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Organization
LIBERATION PROGRAMS INC
Active
Organization
LIBERATION PROGRAMS INC
Active
Other names
Liberation Meridian Guenster
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN MATHIS (CHIEF EXECUTIVE OFFICER)
(203) 851-2077
Entity
Organization
Contact information
Practice address
115 MAIN ST, STAMFORD, CT 06901-2818
(203) 356-1980
(203) 967-9476
Mailing address
4 ELMCREST TER, NORWALK, CT 06850-3908
(203) 851-2077
(203) 851-2082
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SA0175
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANC1781
OXFORD HEALTH PLAN
CT
Enumeration date
04/09/2007
Last updated
08/22/2020
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