| NPI | 1396269361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A PRIBESH Addiction Specialist 203-414-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 000727) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |