Organization
LONG ISLAND COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY L REYNOLDS PH.D (EXECEUTIVE DIRECTOR)
(516) 747-2606
Entity
Organization
Contact information
Practice address
114 OLD COUNTRY RD, SUITE 114, MINEOLA, NY 11501-4420
(516) 747-2606
(516) 747-0714
Mailing address
114 OLD COUNTRY RD, SUITE 114, MINEOLA, NY 11501-4420
(516) 747-2606
(516) 747-0714
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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