| Liberation Programs Inc | |
|
120 Brookside Road Darien CT 06820 | |
| (203) 655-8973 | |
| (203) 655-2389 |
| Full Name | Liberation Programs Inc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 120 Brookside Road, Darien, Connecticut |
| Authorized Official Name and Position | Alan Mathis (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2038512077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberation Programs Inc 4 Elmcrest Ter Norwalk CT 06850-3908 Ph: (203) 851-2077 | Liberation Programs Inc 120 Brookside Road Darien CT 06820 Ph: (203) 655-8973 |
| NPI Number | 1174644652 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174644652 | NPI | - | NPPES |
| 004259025 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 0271 (Connecticut) | Primary |
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