| NPI | 1255972022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED ELSAMRA Owner 203-518-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| 106H00000X Marriage & Family Therapist | |
| 1041C0700X Social Worker Clinical | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-03-10 |