institution
Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic
Substance Use Disorder Rehabilitation Clinic/Center in Mexico, New York
NPI 1164435244

Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic is a Substance Use Disorder Rehabilitation Clinic/Center based in Mexico, NY and is specialized in Rehabilitation, Substance Use Disorder. Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic practices in Mexico, NY. The NPI Number for Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic is 1164435244 and holds a License No. (New York).

The current practice location address for Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic is 3358 Main St, Mexico, NY and can be reached out via phone at 315-963-0777 and via fax at 345-963-0611.

Location: 3358 Main St, Mexico, NY, 13114
institution
Provider Profile Details
NPI Number
1164435244
Provider Name
Stanley Long Dba Harbor Lights Professional Chemical Dependency Servic
Credential
Provider Entity Type
Organization
Address
3358 Main St, Mexico, NY, 13114
Phone Number
315-963-0777
Fax Number
345-963-0611
Provider Enumeration Date
08/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01463294 05 NY
institution
Provider Business Practice Location Address Details
Address
3358 Main St
City
State
Zip
13114
Phone Number
315-963-0777
Fax Number
345-963-0611
person
Provider Business Mailing Address Details
Address
3358 Main St
City
State
Zip
13114
Phone Number
315-963-0777
Fax Number
345-963-0611
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
080211024 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
License No.
()
Definition
Definition to come...
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