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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
399 MILL HILL AVE, BRIDGEPORT, CT 06610-2865
(888) 822-2270
(203) 336-4395
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
0290
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42B
BLUECROSS BLUESHIELD
CT
01
77ABH0051CT01
BLUECROSS BLUESHIELD
CT
Enumeration date
04/09/2007
Last updated
08/22/2020
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