| NPI | 1467075713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KANSINALLY Owner 203-908-5331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |