| City Gate Life Recovery Center, Inc. | |
|
610 Ashland Ave Buffalo NY 14222-1309 | |
| (716) 510-5801 | |
| Not Available |
| Full Name | City Gate Life Recovery Center, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 610 Ashland Ave, Buffalo, New York |
| Authorized Official Name and Position | Carol Conklin (OWNER) |
| Authorized Official Contact | 7168837713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Gate Life Recovery Center, Inc. 610 Ashland Ave Buffalo NY 14222-1309 Ph: (716) 510-5801 | City Gate Life Recovery Center, Inc. 610 Ashland Ave Buffalo NY 14222-1309 Ph: (716) 510-5801 |
| NPI Number | 1285108746 |
|---|---|
| Provider Enumeration Date | 01/17/2019 |
| Last Update Date | 01/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285108746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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