Provider Demographics
NPI:1568530319
Name:PERCEPTION PROGRAMS INC
Entity Type:Organization
Organization Name:PERCEPTION PROGRAMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERWIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-450-7122
Mailing Address - Street 1:842 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2442
Mailing Address - Country:US
Mailing Address - Phone:860-450-7122
Mailing Address - Fax:860-450-7127
Practice Address - Street 1:842 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2442
Practice Address - Country:US
Practice Address - Phone:860-450-7122
Practice Address - Fax:860-450-7152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004217289Medicaid
CT004121589Medicaid