Healthcare Provider Details

I. General information

NPI: 1063668325
Provider Name (Legal Business Name): ALLEGANY REHABILITATION ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N MAIN ST
WARSAW NY
14569-1023
US

IV. Provider business mailing address

422 N MAIN ST
WARSAW NY
14569-1023
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8133
  • Fax: 585-786-9928
Mailing address:
  • Phone: 585-786-8133
  • Fax: 585-786-9928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: BARBARA JEAN MANN
Title or Position: OFFICE MANAGER
Credential:
Phone: 585-786-8133