| NPI | 1922551183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEKEESHA MILLER-JACKSON Executive Director 203-887-7848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC C010256) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C010256) |
| 251S00000X (Licence: CT 009453) | |
| 302R00000X Health Maintenance Organization (Licence: NC C010256) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |