| NPI | 1831463165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY BERGMAN Administration 203-300-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0516) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0428) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-21 |