Organization
ALCOHOL & DRUG COUNCIL OF TOMPKINS COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE TEETER (DIRECTOR OF FINANCE & ADMINISTRATIO)
(607) 274-6288
Entity
Organization
Contact information
Practice address
201 E GREEN ST STE 500, ITHACA, NY 14850-5635
(607) 274-6288
(607) 274-6280
Mailing address
201 E GREEN ST STE 500, ITHACA, NY 14850-5635
(607) 274-6288
(607) 274-6280
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
070410653
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00794101
—
NY
01
—
316304
VALUE OPTIONS PROVIDER ID
NY
01
—
7320013002
GHI PROVIDER ID
NY
Enumeration date
07/19/2006
Last updated
03/25/2015
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