| NPI | 1841750122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION BEALE Acting CFO 203-517-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-09-02 |