| Liberty Treatment Of Virginia | |
|
55 Great Meadow Ln Avon CT 06001-4549 | |
| (959) 226-8411 | |
| Not Available |
| Full Name | Liberty Treatment Of Virginia |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 55 Great Meadow Ln, Avon, Connecticut |
| Authorized Official Name and Position | Gina Rose (OWNER) |
| Authorized Official Contact | 9592268411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Treatment Of Virginia 55 Great Meadow Ln Avon CT 06001-4549 Ph: (959) 226-8411 | Liberty Treatment Of Virginia 55 Great Meadow Ln Avon CT 06001-4549 Ph: (959) 226-8411 |
| NPI Number | 1053173195 |
|---|---|
| Provider Enumeration Date | 01/24/2024 |
| Last Update Date | 01/24/2024 |
| Certification Date | 01/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053173195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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