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
261QM0850X
Adult Mental Health Clinic/Center
Primary
0290
CT
261QM2800X
Methadone Clinic
0290
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004191962
—
CT
05
—
004238764
—
CT
05
—
004251500
—
CT
Enumeration date
03/30/2007
Last updated
06/27/2008
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