| NPI | 1821059486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRVIN R JENNINGS Executive/Medical Director 203-748-5689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT OPCC-20) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 261QM0801X (Licence: CT 0480) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 376J00000X Homemaker (Licence: HCA.0000179) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2024-05-09 |