| NPI | 1366013823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DOMINIC ROSA Board Member 203-910-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2021-07-06 |