Healthcare Provider Details

I. General information

NPI: 1679792238
Provider Name (Legal Business Name): LEXINGTON CENTER FOR RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 NORTH AVE
NEW ROCHELLE NY
10801-4160
US

IV. Provider business mailing address

420 NORTH AVE
NEW ROCHELLE NY
10801-4160
US

V. Phone/Fax

Practice location:
  • Phone: 914-235-6633
  • Fax: 914-666-3319
Mailing address:
  • Phone: 914-235-6633
  • Fax: 914-666-3319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number038229-1
License Number StateNY

VIII. Authorized Official

Name: DR. ADRIENNE MARCUS I
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 914-666-0191