Healthcare Provider Details

I. General information

NPI: 1609789148
Provider Name (Legal Business Name): APT FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 WHALLEY AVE
NEW HAVEN CT
06511-3254
US

IV. Provider business mailing address

1 LONG WHARF DR STE 321
NEW HAVEN CT
06511-5946
US

V. Phone/Fax

Practice location:
  • Phone: 203-781-4600
  • Fax:
Mailing address:
  • Phone: 203-781-4600
  • Fax: 203-781-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: MINERVA BONILLA
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 203-781-4600