| Depaul | |
|
774 W Main St Rochester NY 14611-2331 | |
| (585) 464-8870 | |
| (585) 464-8077 |
| Full Name | Depaul |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 774 W Main St, Rochester, New York |
| Authorized Official Name and Position | Jim Whalen (VICE PRESIDENT, FINANCE) |
| Authorized Official Contact | 5854268000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Depaul 1931 Buffalo Rd Rochester NY 14624-1535 Ph: (585) 426-8000 | Depaul 774 W Main St Rochester NY 14611-2331 Ph: (585) 464-8870 |
| NPI Number | 1417949850 |
|---|---|
| Provider Enumeration Date | 08/22/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417949850 | NPI | - | NPPES |
| 00689721 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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