Organization Name: | FINGER LAKES ADDICTION COUNSELING AND REFERRAL AGENCY |
NPI Number: | 1366434011 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTIN TELLER (EXECUTIVE DIRECTOR) |
Mailing Address: | 28 E Main St Clifton Springs |
State: | NY US |
Postal Code: | 144321231 |
Phone Number: | 3154629466 |
Fax Number: | 3154626400 |
NPI Enumeration Date: | 08/18/2005 |
NPI Last Update Date: | 05/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |