| NPI | 1942964770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA BENCE VP Revenue Cycle Management 203-721-6522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 251S00000X Community/Behavioral Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2025-01-21 |