Organization
THE SALVATION ARMY
Active
Other names
Harbor Light Complex
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN SOUTHWICK (SECRETARY)
(845) 620-7329
Entity
Organization
Contact information
Practice address
1710 PROSPECT AVE E, CLEVELAND, OH 44115-2322
(216) 781-3773
(216) 781-9535
Mailing address
440 W NYACK RD, WEST NYACK, NY 10994-1753
(845) 620-7200
(845) 620-7753
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437103819
NPI
OH
Enumeration date
05/20/2006
Last updated
08/15/2017
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