| NPI | 1942274618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PAUL KEREKES Managing Member 203-676-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 005553) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-08-22 |