| NPI | 1619164183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALVIN MCKEITHEN Cssd/Doc COO Rdinator 203-787-2207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 000631) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |