Organization
CONIFER PARK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA M BETTS (BUSINESS OFFICE MANAGER)
(518) 952-8142
Entity
Organization
Contact information
Practice address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
(518) 952-8142
Mailing address
PO BOX 10092, ALBANY, NY 12201-5092
(518) 952-8408
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
00000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
07/21/2006
Last updated
11/02/2023
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