Healthcare Provider Details

I. General information

NPI: 1003008301
Provider Name (Legal Business Name): CENTER FOR COMMUNITY ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CHAPEL ST STE 701
BROOKLYN NY
11201-1917
US

IV. Provider business mailing address

115 E JEFFERSON ST SUITE 300
SYRACUSE NY
13202-2539
US

V. Phone/Fax

Practice location:
  • Phone: 718-858-9658
  • Fax: 718-858-9670
Mailing address:
  • Phone: 315-422-5638
  • Fax: 315-471-4924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID CONDLIFFE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 917-301-3939