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General NPI Number Information
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NPI Number | 1629181888
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Entity Type | Organization
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Legal Business Name | COUNTY OF OSWEGO COUNCIL ON ALCOHOLISM & ADDICTIONS INC.
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 283 W 2ND ST STE 1
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City | OSWEGO
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State | NY
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Zip | 13126-3812
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Country | US
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Telephone | 315-342-2370
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Fax | 315-342-7570
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Provider Business Mailing Address
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Address Line | 283 W 2ND ST STE 1
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City | OSWEGO
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State | NY
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Zip | 13126-3812
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Country | US
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Telephone | 315-342-2370
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Fax | 315-342-7570
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Authorized Official
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Title or Position | ASSOCIATE EXECUTIVE DIRECTOR
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Name | PENNY GALE GREENE
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Credential | MS, NCC, LMHC
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Telephone | 315-342-2370
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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 | 080510742
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 080510742
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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