MEDICARE: CENTER FOR COMMUNITY ALTERNATIVES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	261QM2800X	Methadone Clinic
2	251B00000X	Case Management Agency	NY
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003008301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR COMMUNITY ALTERNATIVES, INC.

Provider Business Mailing Address
First Line	:	115 E JEFFERSON ST
Second Line	:	SUITE 300
City	:	SYRACUSE
State	:	NY
Zip	:	13202-2539
Country	:	US
Telephone Number	:	315-422-5638
Fax Number	:	315-471-4924

Provider Business Practice Location Address
First Line	:	25 CHAPEL ST STE 701
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-1917
Country	:	US
Telephone Number	:	718-858-9658
Fax Number	:	718-858-9670

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. DAVID CONDLIFFE
Credential	:
Telephone Number	:	917-301-3939

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	09/26/2025

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