| NPI | 1942605118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE F VILLAFUERTE Clinical Social Worker 203-767-3607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 8777) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 8777) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2015-09-05 |