Individual
LORD ADMOZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC - T
Contact information
Practice address
6301 INDUCON DR E, SANBORN, NY 14132-9014
(716) 731-2030
(716) 731-3010
Mailing address
38 OAKGROVE AVE, BUFFALO, NY 14208-1006
(716) 885-3806
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
20688
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20688
CASAC - T
NY
Enumeration date
02/06/2007
Last updated
07/08/2007
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