| NPI | 1427351626 |
|---|---|
| Doing Business As | STATE STREET COUNSELING SERVICES |
| Doing Business As | STATE STREET HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | SOL MARIA GONZALEZ Credentialing Specialist 203-503-3174 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0518) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2020-05-01 |