| NPI | 1609464361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK D LEWIS Founder/CEO 203-815-9546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-07 |