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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