| NPI | 1356831960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Of Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CT SA0567) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT C0677) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |