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ONTARIO COUNTY SUBSTANCE ABUSE

Addiction Substance Use Disorder

Canandaigua, New York

Provider NPI: 1194722017

Organization Information:
Organization Name:  ONTARIO COUNTY SUBSTANCE ABUSE
Organization is not Subpart
Authorized Official:  JUNE  FISHER  DIRECTOR  585-3964189

Practice Location:
3019 COUNTY COMPLEX DR  CANANDAIGUA, NY 14424 US
Tel: 585-396-4189  Fax: 585-393-2916

Business Mailing Address:
3019 COUNTY COMPLEX DR  CANANDAIGUA, NY 14424 US
Tel: 585-396-4189  Fax: 585-393-2916

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Other Provider Identifiers:

IssuerNumberStateType
01899687NY05
BLUE CROSS AND BLUE SHIELP0140037OCNY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS NY - Page 1



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