Organization
CG&D ALCOHOLISM AND ADDICTION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA G COOPER (PROGRAM DIRECTOR, CASAC, LPC)
(631) 691-0769
Entity
Organization
Contact information
Practice address
45 DIXON AVE, AMITYVILLE, NY 11701-2809
(631) 691-0769
Mailing address
45 DIXON AVE, AMITYVILLE, NY 11701-2809
(631) 691-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02153551
—
NY
01
—
338178
VALUE OPTIONS
—
Enumeration date
11/20/2006
Last updated
02/26/2008
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