Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CHARLES BORG PH.D. (PSYCHOLOGIST)
(315) 772-8801
Entity
Organization
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-5438
(315) 772-8801
(315) 772-4097
Mailing address
11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-5438
(315) 772-8801
(315) 772-4097
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
ICAADC 952
ID
Other
Enumeration date
11/08/2005
Last updated
08/22/2020
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