Organization
CS MEDICAL ASSOCIATES, P.C.
Active
Other names
Victory Recovery Partners
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY WALLACE (VP OPERATIONS)
(631) 696-4357
Entity
Organization
Contact information
Practice address
250 FULTON AVE STE 607, HEMPSTEAD, NY 11550-3901
(631) 696-4357
Mailing address
100 GRANNY RD, FARMINGVILLE, NY 11738-2879
(631) 696-4357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05150629
—
NY
Enumeration date
05/26/2022
Last updated
05/26/2022
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