Organization
LEWIS COUNTY COMMUNITY SERVICES BOARD
Active
Organization
LEWIS COUNTY COMMUNITY SERVICES BOARD
Active
Other names
Lewis County Community Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L DYER LMSW (CLINIC DIRECTOR)
(315) 376-5958
Entity
Organization
Contact information
Practice address
7714 NUMBER THREE RD, LOWVILLE, NY 13367-3521
(315) 376-5958
(315) 376-5953
Mailing address
7714 NUMBER THREE RD, LOWVILLE, NY 13367-3521
(315) 376-5958
(315) 376-5953
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000458
EXCELLUS
NY
05
—
00657649
—
NY
Enumeration date
09/20/2006
Last updated
08/22/2020
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