| NPI | 1447858394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA ELIZABETH KELLY Medical Director 203-954-9412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |