| NPI | 1649405887 |
|---|---|
| Doing Business As | LEGION AVENUE CLINIC |
| Entity Type | Organization |
| Authorized Contact | LYNN M MADDEN President/CEO 203-781-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0476) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2017-02-21 |