| NPI | 1578969093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KINSELLA Owner 203-681-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 6367) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 974) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2018-12-11 |