| NPI | 1780290916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATY LEE Member 203-515-3978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |