NPI | 1942323571 |
---|---|
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 SA0175) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2020-08-22 |