| NPI | 1629581392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SANTIAGO Insurance Specialist 203-278-9131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 3051) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |