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General NPI Number Information
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NPI Number | 1215346531
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Entity Type | Organization
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Legal Business Name | CAZENOVIA RECOVERY SYSTEMS, INC.
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 9136 SANDROCK RD
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City | EDEN
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State | NY
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Zip | 14057-9526
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Country | US
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Telephone | 716-992-4972
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Fax | 716-992-4791
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Provider Business Mailing Address
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Address Line | 2495 MAIN ST STE 417
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City | BUFFALO
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State | NY
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Zip | 14214-2152
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Country | US
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Telephone | 716-852-4331
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Fax | 716-852-4533
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Authorized Official
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Title or Position | CEO
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Name | LINDSAY HERNDON
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Credential |
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Telephone | 716-314-5903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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