Organization
CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P SCORDO CASAC (EXECUTIVE DIRECTOR)
(315) 788-1530
Entity
Organization
Contact information
Practice address
24180 COUNTY ROUTE 16, EVANS MILLS, NY 13637-3127
(315) 788-1530
(315) 788-3794
Mailing address
595 W MAIN ST, WATERTOWN, NY 13601-1335
(315) 788-1530
(315) 788-3794
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
141011632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02996752
—
NY
Enumeration date
07/01/2014
Last updated
07/01/2014
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