Organization
M A STUTZMAN ADDICTION TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A LAWLER (ASSOCIATE COMMISSIONER DIVISION OF)
(518) 457-5312
Entity
Organization
Contact information
Practice address
360 FOREST AVENUE, BUFFALO, NY 14213-1298
(716) 882-4900
(716) 882-4426
Mailing address
360 FOREST AVENUE, BUFFALO, NY 14213-1298
(716) 882-4900
(716) 882-4426
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01423394
—
NY
Enumeration date
10/19/2006
Last updated
08/22/2020
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