| NPI | 1518413376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GILLAM Director Of Operations 203-293-1589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |