| NPI | 1558765420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NUSS Partner 203-200-8556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ Med5851) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |