| NPI | 1730124025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI KRITSOVAS Medical Director 203-571-9673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2022-02-22 |