| NPI | 1770145286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANIKA RUCKER Member/Owner 203-296-3345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |