NPI 1801201330

Time for a Change Ministry

Organisation Substance Abuse Rehabilitation Facility Bridgeport, CT

Practice location

Address: 880 Hancock Ave, Bridgeport, CT 06605-1930
Phone: (203) 818-5091
Fax: (203) 923-8472

Authorised official

Name: Lou Holiday
Title: Supervisor
Phone: (203) 818-5091

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 17053333309021 (CT)

Other Substance Abuse Rehabilitation Facility providers in Connecticut →

Registry record

NPI: 1801201330
Entity type: Organization
NPI issued: 23 Jun 2014
Record last updated: 23 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.