| NPI | 1457999880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE CULLEN Medical Billing Manager 203-367-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |