| Allegany Council On Alcoholism And Substance Abuse, Inc. | |
|
2956 Airway Rd Wellsville NY 14895-9329 | |
| (585) 593-6738 | |
| Not Available |
| Full Name | Allegany Council On Alcoholism And Substance Abuse, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2956 Airway Rd, Wellsville, New York |
| Authorized Official Name and Position | William Penman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5855931920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allegany Council On Alcoholism And Substance Abuse, Inc. 3084 County Road 30 Wellsville NY 14895-9445 Ph: (585) 593-1920 | Allegany Council On Alcoholism And Substance Abuse, Inc. 2956 Airway Rd Wellsville NY 14895-9329 Ph: (585) 593-6738 |
| NPI Number | 1316083934 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 04/18/2022 |
| Certification Date | 04/18/2022 |
| Medicare PECOS PAC ID | 7618353269 |
|---|---|
| Medicare Enrollment ID | O20221005000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316083934 | NPI | - | NPPES |
| 00618180 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 071010658 (New York) | Primary |
| Provider Name | Mary S Nobilski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265518179 PECOS PAC ID: 2961481247 Enrollment ID: I20040719001517 |
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