| NPI | 1972210623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BUSTER Owner 203-751-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-12-27 |