| NPI | 1306350228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH G BENNER Owner 203-666-1605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CT 3519) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1234) |
| 101YM0800X Counselor, Mental Health (Licence: CT 3519) | |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2023-07-14 |