| NPI | 1568998706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA MILLER Patients Account Manager 203-743-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 104100000) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-09 |