| NPI | 1437616257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A PEACOCK Owner/Sole Proprietor/Director 203-609-3602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2020-08-17 |