NPI | 1598279689 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON BRADWAY Director Information Systems 203-568-7466 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0067) |
Enumeration Date | 2017-11-28 |
Last Update Date | 2017-11-28 |