| NPI | 1770097867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CT 0533) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |