Organization
LIBERATION PROGRAMS INC
Active
Other names
LiberationMeridian 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
55 OLD FIELD POINT RD, GREENWICH, CT 06830-6149
(203) 869-1349
(203) 352-1806
Mailing address
4 ELMCREST TER, NORWALK, CT 06850-3908
(203) 851-2077
(203) 851-2082
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0223
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004258374
—
CT
Enumeration date
03/30/2007
Last updated
06/27/2008
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