Provider First Line Business Practice Location Address:
950 CAMPBELL AVE
Provider Second Line Business Practice Location Address:
VAMC, #116A, MENTAL HEALTH CLINIC
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-932-5711
Provider Business Practice Location Address Fax Number:
203-937-4789
Provider Enumeration Date:
08/31/2006