Organization
TIME FOR A CHANGE MINISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOU HOLIDAY (SUPERVISOR)
(203) 818-5091
Entity
Organization
Contact information
Practice address
880 HANCOCK AVE, BRIDGEPORT, CT 06605-1930
(203) 818-5091
(203) 923-8472
Mailing address
880 HANCOCK AVE, BRIDGEPORT, CT 06605-1930
(203) 818-5091
(203) 923-8472
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
17053333309021
CT
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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