NPI | 1720866916 |
---|---|
Doing Business As | KETAMINE CENTER OF CONNECTICUT |
Entity Type | Organization |
Authorized Contact | AL GENE EJUSA ANG Office Manager 860-552-7592 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-09-19 |
Last Update Date | 2023-11-30 |