| NPI | 1942755764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE SORENSEN KOSCHNITZKE Owner 203-564-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 8835) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |