Provider First Line Business Practice Location Address:
1635 CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
SOUTHWEST CONNECTICUT MENTAL HEALTH SYSTEM
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-551-7660
Provider Business Practice Location Address Fax Number:
203-651-7481
Provider Enumeration Date:
11/15/2006