NPI | 1689491128 |
---|---|
Entity Type | Organization |
Authorized Contact | EBENEZER ADEKUNLE KOLADE Member 203-803-7428 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
207RA0401X Internal Medicine, Addiction Medicine | |
261QM0850X Clinic/Center, Adult Mental Health | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2024-09-25 |
Last Update Date | 2024-09-25 |