| NPI | 1417764390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELBY SANDOVAL Manager/Owner 203-805-9744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-12-14 |
| Last Update Date | 2024-12-14 |