Lake Shore Behavioral Health, Inc | |
254 Franklin St Buffalo NY 14202-1902 | |
(716) 842-0440 | |
(716) 842-4069 |
Full Name | Lake Shore Behavioral Health, Inc |
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Speciality | Counselor - Mental Health |
Location | 254 Franklin St, Buffalo, New York |
Authorized Official Name and Position | Howard Hitzel (PRESIDENT) |
Authorized Official Contact | 7168420440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Shore Behavioral Health, Inc 254 Franklin St Buffalo NY 14202-1902 Ph: (716) 842-0440 | Lake Shore Behavioral Health, Inc 254 Franklin St Buffalo NY 14202-1902 Ph: (716) 842-0440 |
NPI Number | 1639391204 |
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Provider Enumeration Date | 05/03/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639391204 | NPI | - | NPPES |
00671765 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6783420A (New York) | Primary |
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