| NPI | 1679768725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN CUSHING Clinician 203-772-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001213) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |