Organization
ALLIANCE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK MURADIAN PHD (EXECUTIVE DIRECTOR)
(860) 826-1358
Entity
Organization
Contact information
Practice address
121 W AVON RD, AVON, CT 06001-3506
(860) 673-6115
(860) 675-7433
Mailing address
35 RUSSELL ST, NEW BRITAIN, CT 06052-1312
(860) 229-8887
(860) 229-8886
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100
ANTHEM PROV. NUMBER
CT
01
—
50B
ANTHEM PROV. NUMBER
CT
01
—
B00537
SAGA GROUP/LOCATION #
CT
01
—
CTGA000469
SAGA PROVIDER NUMBER
CT
Enumeration date
10/24/2006
Last updated
08/22/2020
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