| NPI | 1649417510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA B CARLSSON Medical Biller 203-322-1479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 09529) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |