| NPI | 1437569738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALI FORTUNA Counselor 203-257-2654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 1083) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-05-07 |