Provider Demographics
NPI:1780987099
Name:APT FOUNDATION INC
Entity type:Organization
Organization Name:APT FOUNDATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
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:STE 321
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 1:1 LONG WHARF DR
Practice Address - Street 2:STE 321
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-781-4600
Practice Address - Fax:203-781-4624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0230261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008003745OtherDESROSIERS MEDICAID
CT008038037OtherEGGERT MEDICAID
CT008038052OtherNODELMAN MEDICAID
CT008070113Medicaid
CT001218107OtherSCHOTTENFELD MEDICAID
CT008001325OtherLEGION/MEDICAID/SA
CT008045323OtherGARCIA MEDICAID
CT008061961OtherSMALL-OIE MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT001302497OtherSHI MEDICAID
CT001423136OtherTETRAULT MEDICAID
CT008038053OtherROEHRICH MEDICAID
CT008053091OtherBUTNER MEDICAID
CT008069472OtherPOTWARDOWSKI MEDICAID
CT008066293OtherMARDAM BEY MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT008048393OtherBARRY MEDICAID
CT008050785OtherDROZD MEDICAID
CTD400316058Medicare PIN
CTD400362888Medicare PIN
CT008050785OtherDROZD MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT008066293OtherMARDAM BEY MEDICAID
CT008070113Medicaid
CT008069472OtherPOTWARDOWSKI MEDICAID
CT008003745OtherDESROSIERS MEDICAID
CTD400082725Medicare PIN
CT008020943OtherMARIENFELD MEDICAID
CTD400081097OtherTETRAULT MEDICARE
CTD400081097OtherTETRAULT MEDICARE
CTD400081097OtherTETRAULT MEDICARE