| NPI | 1972588895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADAR LUBIN Co Director 203-624-2146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 001420) |
| 103T00000X Psychologist (Licence: CT 0892) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 032090) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2012-03-16 |