Provider Demographics
NPI:1821779299
Name:RELATIONAL ABUSE RESOURCE CENTER LLC
Entity Type:Organization
Organization Name:RELATIONAL ABUSE RESOURCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDERER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-335-7671
Mailing Address - Street 1:4 JARVIS ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2824
Mailing Address - Country:US
Mailing Address - Phone:203-306-5855
Mailing Address - Fax:
Practice Address - Street 1:180 POST RD E STE 208
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3414
Practice Address - Country:US
Practice Address - Phone:203-306-5855
Practice Address - Fax:203-308-5585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health