| |
326 Orchard Park Rd West Seneca NY 14224-2635 | |
(716) 662-6638 | |
(716) 823-0751 |
Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 326 Orchard Park Rd, West Seneca, New York |
Authorized Official Name and Position | Bruce Nisbet (PRESIDENT/CEO) |
Authorized Official Contact | 7166622040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
227 Thorn Ave Box 631 Orchard Park NY 14127-2600 Ph: (716) 662-2040 | 326 Orchard Park Rd West Seneca NY 14224-2635 Ph: (716) 662-6638 |
NPI Number | 1821263682 |
---|---|
Provider Enumeration Date | 04/23/2008 |
Last Update Date | 07/19/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821263682 | NPI | - | NPPES |
00660577 | Medicaid | NY | |
040727000154 | Other | NY | MED. MAN CARE |
040727000154 | Other | NY | FIDELIS |
8401220 | Other | NY | IHA |
000000812000 | Other | NY | BCBS |
00011227702 | Other | NY | UNIVERA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 091110871 (New York) | Primary |
Vitality Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Gardenville Pkwy W Ste 114, West Seneca, NY 14224 Phone: 716-202-8428 | |