NPI 1689491128 · live from the CMS NPI Registry
Access Recovery LLC
Clinic/Center, Methadone Clinic in Bridgeport, CT. National Provider Identifier 1689491128, active.
NPI record
| NPI | 1689491128 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Methadone Clinic 261QM2800X |
| Practice location | 4675 Main St, Bridgeport, CT 06606 |
| Practice phone | 203-372-3333 |
| Enumerated | September 25, 2024 |
| Last updated | September 25, 2024 |
| Authorized official | Ebenezer Kolade, Member |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Addiction Medicine | 207QA0401X | — |
| Internal Medicine, Addiction Medicine | 207RA0401X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Clinic/Center, Methadone Clinic primary | 261QM2800X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder | 261QR0405X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.