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General NPI Number Information
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NPI Number | 1225443211
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Entity Type | Organization
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Legal Business Name | COUNCIL ON ADDICTION RECOVERY SERVICES INC
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 1351 OLEAN - PORTVILLE RD
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City | WESTONS MILLS
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State | NY
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Zip | 14788
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Country | US
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Telephone | 716-373-0057
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Fax | 716-373-7910
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Provider Business Mailing Address
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Address Line | 201 S UNION ST
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City | OLEAN
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State | NY
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Zip | 14760-3646
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Country | US
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Telephone | 716-373-4303
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Fax | 716-373-4327
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHAEL H PRUTSMAN
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Credential | CPP, MA
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Telephone | 716-373-4303
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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 | 160310173
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License Number State | NY
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