| Organization Name: | STANLEY LONG DBA HARBOR LIGHTS PROFESSIONAL CHEMICAL DEPENDENCY SERVIC |
| NPI Number: | 1164435244 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STANLEY E LONG (OWNER) |
| Mailing Address: | 3358 Main St Mexico |
| State: | NY US |
| Postal Code: | 13114 |
| Phone Number: | 3159630777 |
| Fax Number: | 3459630611 |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 07/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |