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Contact Information

CREEDMOOR ADDICTION TREATMENT CENTER
80 45 WINCHESTER BOULEVARD
BUILDING 19 CBU 15
QUEENS VILLAGE, NY11427
 Phone: 718-264-3740
 Fax: 718-776-5145
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for CREEDMOOR ADDICTION TREATMENT CENTER

NPI Number 1619059052
LBN Legal business name CREEDMOOR ADDICTION TREATMENT CENTER
Authorized official MICHAEL LAWLER - (ASSOCIATE COMMISSIONER, DIVISION OF)
Entity Organization
Organization subpart 1 No
Enumeration date 10/19/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NY Medicaid 01438233
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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