| NPI | 1174644652 |
|---|---|
| Former Legal Business Name | LIBERATION MERIDIAN GUENSTER |
| Entity Type | Organization |
| Authorized Contact | ALAN MATHIS Chief Executive Officer 203-851-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT 0271) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-06-27 |