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Organization
TRACTORHEALTHSOLUTIONS LLC
Active
Organization
TRACTORHEALTHSOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM LATIMER LCSW R (CEO)
64672495767
Entity
Organization
Contact information
Practice address
243 BAYARD STREET, # 724, PORT EWEN, NY 12466
(646) 249-5767
Mailing address
243 BAYARD STREET, # 724, PORT EWEN, NY 12466
(646) 249-5767
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23700
NY
1041C0700X
Clinical Social Worker
Primary
080579
NY
171M00000X
Case Manager/Care Coordinator
080579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03589764
—
NY
Enumeration date
08/04/2016
Last updated
08/11/2016
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