Provider Demographics
NPI:1104184670
Name:APT FOUNDATION, INC
Entity Type:Organization
Organization Name:APT FOUNDATION, INC
Other - Org Name:RESIDENTIAL SERVICES DIVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:203-781-4600
Mailing Address - Street 1:1 LONG WHARF DR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5991
Mailing Address - Country:US
Mailing Address - Phone:203-781-4600
Mailing Address - Fax:203-781-4624
Practice Address - Street 1:54 E RAMSDELL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1140
Practice Address - Country:US
Practice Address - Phone:203-337-9943
Practice Address - Fax:203-387-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001423136OtherTETRAULT MEDICAID
CT008030353OtherFELDMAN MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT008069619OtherPARISI MEDICAID
CT008038186OtherIEAD MEDICAID
CT008070148OtherBURGDORFER MEDICAID
CT008042339OtherRSD/MEDICAID/MMT
CT008045348OtherTAVERNER MEDICAID
CT008003745OtherDESROSIERS MEDICAID
CT001302497OtherSHI MEDICAID
CT008023170OtherWILLIAMS MEDICAID
CT008053091OtherBUTNER MEDICAID
CT008058232OtherANDERSON MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT008056047OtherROSS MEDICAID
CT008056047OtherROSS MEDICAID
CT001302497OtherSHI MEDICAID
CT008038186OtherIEAD MEDICAID
CT008045348OtherTAVERNER MEDICAID
CT008058232OtherANDERSON MEDICAID
CT001423136OtherTETRAULT MEDICAID
CTD400357444Medicare PIN
CTD400083844OtherDESROSIERS MEDICARE
CT008038188OtherREILLY MEDICAID
CT001302497OtherSHI MEDICAID
CT008030943OtherMARIENFELD MEDICAID
CT008053091OtherBUTNER MEDICAID
CTD400083844OtherDESROSIERS MEDICARE
CT001340132OtherSAVAGE MEDICAID