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General NPI Number Information
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NPI Number | 1437101417
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Entity Type | Organization
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Legal Business Name | THE ADDICTIONS CARE CENTER OF ALBANY, INC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 1044 BROADWAY
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City | ALBANY
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State | NY
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Zip | 12204
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Country | US
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Telephone | 518-434-2367
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Fax | 518-434-2372
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Provider Business Mailing Address
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Address Line | 90 MCCARTY AVENUE ADMINISTRATION-BLDG 1
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City | ALBANY
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State | NY
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Zip | 12202-1151
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Country | US
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Telephone | 518-465-5470
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Fax | 518-427-0854
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. KEITH W STACK
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Credential |
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Telephone | 518-465-5470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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