National Provider Identifier
Conifer Park, Inc.
Conifer Park, Inc. is listed in the NPPES registry with a primary specialty of Substance Use Disorder Rehabilitation Clinic/Center in Rochester, NY and a listed phone number of (585) 442-8422.
Profile Overview
- NPI
- 1235185612
- Provider Type
- Organization
- Primary Specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Enumeration Date
- May 26, 2006
- Last Updated
- April 29, 2021
Practice Location
- 556 Clinton Ave S
- Rochester, NY 14620-1105
Phone: (585) 442-8422
Mailing Address
- PO Box 10092
- Albany, NY 12201-5092
Specialties
- Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)
Full Record
- NPI
- 1235185612
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Conifer Park, Inc.
- Mailing Street Address
- PO Box 10092
- Mailing City
- Albany
- Mailing State
- NY
- Mailing ZIP Code
- 12201-5092
- Mailing Country
- US
- Mailing Phone
- (518) 952-8408
- Mailing Fax
- (518) 399-6860
- Practice Street Address
- 556 Clinton Ave S
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-1105
- Practice Country
- US
- Practice Phone
- (585) 442-8422
- Enumeration Date
- May 26, 2006
- Last Updated
- April 29, 2021
- Authorized Official Last Name
- Smith
- Authorized Official First Name
- Tammy
- Authorized Official Title
- Director, Op Billing Dept
- Authorized Official Phone
- (518) 952-8408
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- MS.
- Certification Date
- April 29, 2021
- Taxonomies
- Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)
- Other Identifiers
- 01420800 (NY)