| NPI | 1861053183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMOND KENYUTTA TILLMAN Substance Abuse Therapist 203-243-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |