Healthcare Provider Details

I. General information

NPI: 1174607535
Provider Name (Legal Business Name): ALLIANCE TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W AVON RD
AVON CT
06001-3506
US

IV. Provider business mailing address

35 RUSSELL ST
NEW BRITAIN CT
06052-1312
US

V. Phone/Fax

Practice location:
  • Phone: 860-673-6115
  • Fax: 860-675-7433
Mailing address:
  • Phone: 860-229-8887
  • Fax: 860-229-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK MURADIAN
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 860-826-1358