| NPI | 1932895182 |
|---|---|
| Doing Business As | STAMFORD OUTPATIENT BEHAVIORAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARVIN TRACEY Director Of Accounts Receivable 203-929-1954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |