| NPI | 1780189480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Of Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT MHDT0070) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2018-03-26 |