Healthcare Provider Details

I. General information

NPI: 1174396683
Provider Name (Legal Business Name): WINDHAM FALLS RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2774 ROUTE 42
WEST KILL NY
12492-5101
US

IV. Provider business mailing address

516 SYLVAN AVE
ENGLEWOOD CLIFFS NJ
07632-3022
US

V. Phone/Fax

Practice location:
  • Phone: 347-622-3605
  • Fax:
Mailing address:
  • Phone: 347-622-3605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TUVIA FRIEDMAN
Title or Position: PARTNER
Credential:
Phone: 347-622-3605