| NPI | 1316067481 |
|---|---|
| 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 | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0290) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CT 0290) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-06-27 |