| NPI | 1316060940 |
|---|---|
| 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 | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 0290) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |