| NPI | 1609296904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY J BERNARD Owner 203-449-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 006662) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |