Organization
CONNECTICUT VALLEY RECOVERY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFTON FREDERICK LORD MD (PRESIDENT)
(802) 356-6496
Entity
Organization
Contact information
Practice address
141 ETTA FRASIER DR, WINDSOR, VT 05089-1315
(802) 674-9400
(802) 674-9410
Mailing address
141 ETTA FRASIER DR, WINDSOR, VT 05089-1315
(802) 674-9400
(802) 674-9410
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006638
—
VT
Enumeration date
05/03/2007
Last updated
06/08/2020
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