| NPI | 1629643465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Of Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |