Organization
CENTER FOR ADDICTION RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLE A. PETTERSEN (EXECUTIVE DIRECTOR)
(315) 853-7111
Entity
Organization
Contact information
Practice address
7930 LIMBERLOST RD, CLINTON, NY 13323-3606
(315) 853-7111
(315) 853-7762
Mailing address
7930 LIMBERLOST RD, CLINTON, NY 13323-3606
(315) 853-7111
(315) 853-7762
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01749242
—
NY
Enumeration date
11/28/2006
Last updated
08/22/2020
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