| Re Blaisdell Addiction Treatment Center | |
|
140 Old Orangeburg Rd Building 57 Orangeburg NY 10962-1157 | |
| (845) 359-8500 | |
| (845) 680-5510 |
| Full Name | Re Blaisdell Addiction Treatment Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 140 Old Orangeburg Rd, Orangeburg, New York |
| Authorized Official Name and Position | Michael A Lawler (ASSOC COMMISIONER DIV OF FINANCIAL) |
| Authorized Official Contact | 5184575312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Re Blaisdell Addiction Treatment Center Box 140 Orangeburg NY 10962-1129 Ph: (845) 359-8500 | Re Blaisdell Addiction Treatment Center 140 Old Orangeburg Rd Building 57 Orangeburg NY 10962-1157 Ph: (845) 359-8500 |
| NPI Number | 1366526105 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366526105 | NPI | - | NPPES |
| 01432333 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New York) | Primary |
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