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General NPI Number Information
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NPI Number | 1285029611
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Entity Type | Organization
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Legal Business Name | FAIRVIEW RECOVERY SERVICES, INC
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 5 MERRICK ST
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City | BINGHAMTON
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State | NY
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Zip | 13904
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Country | US
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Telephone | 607-722-8987
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Fax | 607-722-6767
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Provider Business Mailing Address
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Address Line | 5 MERRICK ST
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City | BINGHAMTON
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State | NY
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Zip | 13904
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Country | US
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Telephone | 607-722-8987
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Fax | 607-722-6767
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MICHELE ANN NAPOLITANO
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Credential | CRC, CASAC
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Telephone | 607-722-8987
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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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