| NPI | 1316289531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID STERN Owner 203-213-9987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001882) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CT 000823) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |