Organization
CAYUGA ADDICTION RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY MICHAEL LAMBERT JOHNSTON LMSW (PRIMARY ADDICTIONS COUNSELOR)
(607) 273-5500
Entity
Organization
Contact information
Practice address
334 W STATE ST, ITHACA, NY 14850-5432
(607) 273-5500
Mailing address
477 NELSON RD, APARTMENT, ITHACA, NY 14850-9437
(607) 229-0170
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095740
NYS OFFICE OF THE PROFESSIONS - LMSW
NY
Enumeration date
08/20/2015
Last updated
08/20/2015
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