Provider Demographics
NPI:1689225849
Name:SPECIALIZED TREATMENT SERVICES, LLC
Entity Type:Organization
Organization Name:SPECIALIZED TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORECKA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-929-2400
Mailing Address - Street 1:1000 BRIDGEPORT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4660
Mailing Address - Country:US
Mailing Address - Phone:203-929-2400
Mailing Address - Fax:203-929-5202
Practice Address - Street 1:1000 BRIDGEPORT AVE STE 101
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4660
Practice Address - Country:US
Practice Address - Phone:203-929-2400
Practice Address - Fax:203-929-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty