Organization
SUFFOLK COUNTY DUAL RECOVERY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HICKMAN LCSW CASAC (PROGRAM DIRECTOR)
(631) 854-2571
Entity
Organization
Contact information
Practice address
15 HORSEBLOCK PL, FARMINGVILLE, NY 11738-1204
(631) 854-2571
Mailing address
15 HORSEBLOCK PL, FARMINGVILLE, NY 11738-1204
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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