Healthcare Provider Details

I. General information

NPI: 1891907507
Provider Name (Legal Business Name): BESTSELF BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3176 ABBOTT RD UNIT 500
ORCHARD PARK NY
14127-1069
US

IV. Provider business mailing address

255 DELAWARE AVENUE SUITE 300
BUFFALO NY
14202-2017
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-2117
  • Fax: 716-842-4069
Mailing address:
  • Phone: 716-842-0440
  • Fax: 716-842-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH WOIKE-GANGA
Title or Position: PRESIDENT & CEO
Credential: LCSW-R
Phone: 716-842-0440