Organization · Type 2 NPI
Stanley Long dba Harbor Lights Professional Chemical Dependency Servic
Substance Use Disorder Rehabilitation Clinic/Center · Mexico, NY
NPI number
1164435244
Active
Practice location
3358 Main St
Mexico, NY 13114
Fax (345) 963-0611
Mailing address
PO Box 716, 3358 Main St
Mexico, NY 13114
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 080211024 (NY) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
3 other providers at this address
About NPI 1164435244
Stanley Long dba Harbor Lights Professional Chemical Dependency Servic's National Provider Identifier is 1164435244, issued on Aug 13, 2006. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Mexico, NY. The record was last updated on Jul 17, 2008.