CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS (NPI# 1740695568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740695568 |
| Entity Type | Organization |
| Organization Name | CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS |
| Practice Address |
24180 County Route 16 Evans Mills NY 13637-3127 |
| Mailing Address |
595 W Main St Watertown NY 13601-1335 |
| Practice Telephone | 3157881530 |
| Practice Fax Number | 3157883794 |
| Mailing Telephone | 3157881530 |
| Mailing Fax Number | 3157883794 |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |
| Authorized Official Name | JAMES P SCORDO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3157881530 |
| Authorized Official Credential | CASAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 141011632 | NY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02996752 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760630073 | Credo Community Center for The Treatment of Addictions | Community/Behavioral Health | 595 W Main St, Watertown, NY 13601 | 2008-08-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC | 595 W Main St, Watertown, NY 13601-1335 |
| Street Address |
24180 COUNTY ROUTE 16 |
| City | EVANS MILLS |
| State | NY |
| Zip Code | 13637-3127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760639231 | Leon France | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-26 |
| 1699923524 | John Wilson | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-09-04 |
| 1740438936 | Lloyd Mitchell | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-09-03 |
| 1336396852 | Christine Massey | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-27 |
| 1942457460 | Sandi Lindi | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-27 |
| 1790932218 | Mark Trimm | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-27 |
| 1285881714 | Jennifer Lachenauer | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-27 |
| 1821245341 | Greg Matukas | Counselor | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780953257 | Indian River Central School | Local Education Agency (LEA) | 8442 S Main Street, Evans Mills, NY 13637 | 2011-12-29 |
| 1467766782 | Daniel W Krebs | Family Medicine | 26908 Independence Way, Samaritan Family Health Center - Leray, Evans Mills, NY 13637 | 2010-07-28 |
| 1427370774 | David Stetson Bombard | Pharmacist | 25737 Us Rt 11, Evans Mills, NY 13637 | 2010-02-26 |
| 1467663344 | Carthage Area Hospital Inc. | Obstetrics & Gynecology | Route 11 Freedom Plaza, Evans Mills, NY 13637 | 2007-05-24 |
| 1437230992 | Shara Peets | Specialist | Us Rt. 11, Evans Mills, NY 13637 | 2006-10-18 |
| 1134442379 | Jennifer Joyce Kerley | Pharmacist | 25737 Us Route 11, Evans Mills, NY 13637 | 2010-03-02 |
| 1366530958 | Evans Mills Volunteer Ambulance Squad Inc | Ambulance | 8733 Factory St, Evans Mills, NY 13637-0113 | 2006-10-10 |
| 1891862314 | Evans Mills Volunteer Ambulance Squad Inc | Ambulance | 8733 Factory St, Evans Mills, NY 13637-0113 | 2006-11-29 |
| 1063923167 | Alyse Munoz | Social Worker | 25659 County Route 16, Evans Mills, NY 13637-3104 | 2017-10-16 |
| 1588296438 | Viviana Marcel Ruiz | Counselor | 25851 Keyser Rd, Evans Mills, NY 13637-3133 | 2020-02-09 |
| Find all providers in zip 13637 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992337224 | Council On Addiction Recovery Services, Inc. | Substance Abuse Rehabilitation Facility | 1355 Olean-portville Road, Westons Mills, NY 14788-1476 | 2020-02-05 |
| 1528609799 | Ebdk At Calverton | Substance Abuse Rehabilitation Facility | 525 Jan Way, Calverton, NY 11933-3005 | 2019-09-30 |
| 1124679998 | Resource Recovery Center of Orange County LLC | Substance Abuse Rehabilitation Facility | 68 Crystal Run Rd, Middletown, NY 10941-7100 | 2019-09-24 |
| 1326506064 | Mountainside - Huntington | Substance Abuse Rehabilitation Facility | 141 E Main St Ste 2, Huntington, NY 11743-2850 | 2019-03-12 |
| 1023589090 | Argus Community, Inc. | Substance Abuse Rehabilitation Facility | 2015-25 Madison Avenue, 4th Floor, New York, NY 10035-1015 | 2018-12-16 |
| 1578030797 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave, Albany, NY 12206-2408 | 2018-10-25 |
| 1467949867 | Ocean Recovery East LLC | Substance Abuse Rehabilitation Facility | 113 E 60th St, New York, NY 10022-1939 | 2018-04-20 |
| 1578050944 | Elev8 Center New York, LLC | Substance Abuse Rehabilitation Facility | 151 W 136th St, New York, NY 10030-2606 | 2018-04-20 |
| 1518491174 | Aaron Smith | Substance Abuse Rehabilitation Facility | 460 Brielle Ave, Building H, Staten Island, NY 10314 | 2017-04-20 |
| 1346772019 | Catholic Charities of The Diocese of Rockville Centre | Substance Abuse Rehabilitation Facility | 30 Carlough Rd Ste C, Bohemia, NY 11716-2919 | 2017-03-31 |
| Find all providers with the same taxonomy | ||||
| City | EVANS MILLS |
| Zip Code | 13637 |
Please comment or provide details below to improve the information on CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.