| Organization Name: | ST. PETERS ADICTION RECOVERY CENTER |
| NPI Number: | 1386795300 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NOREEN MARIE GALEO (CASAC IN TRAINING) |
| Mailing Address: | 433 Geyser Rd Ballston Spa |
| State: | NY US |
| Postal Code: | 12020 |
| Phone Number: | 5188856884 |
| Fax Number: | 5188850077 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 18075 |
| 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: | |