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General NPI Number Information
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NPI Number | 1992337224
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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 | 02/05/2020
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 1355 OLEAN-PORTVILLE ROAD
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City | WESTONS MILLS
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State | NY
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Zip | 14788-1476
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Country | US
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Telephone | 716-373-0021
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Fax | 716-373-1719
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Provider Business Mailing Address
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Address Line | PO BOX 567
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City | OLEAN
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State | NY
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Zip | 14760-0567
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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 | EXC ADMIN ASST/COMPLIANCE
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Name | M'LISSA MARIE SUGDEN
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Credential | RHIA
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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 |
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License Number State |
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