| NPI | 1326882671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAURICE CRENSHAW Clinical Administrator 203-915-9282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-07-01 |