| NPI | 1669698601 |
|---|---|
| Other Name | ST. PETER'S ADDICTION RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing & Enrollment Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 0101004H) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 282N00000X General Acute Care Hospital (Licence: NY 0101004H) | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-07-14 |