| NPI | 1255042982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER BROOKS Owner 203-901-2493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2023-04-28 |