| NPI | 1740587526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SUSAN GRISGRABER Ap Rn2035565225 203-556-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: CT 001868) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2016-10-05 |