CONIFER PARK INC. NPI 1346296720

NPI Information

NPI: 1346296720
Provider Name: CONIFER PARK, INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 33D2028445

Address:
80 SHARRON AVE
PLATTSBURGH, NY
ZIP 12901
Phone: (518) 561-1447
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CONIFER PARK, INC. is a rehabilitation and substance use disorder clinic center in Plattsburgh, NY. CONIFER PARK, INC. NPI is 1346296720. The provider is registered as an organization entity type.

The provider's business location address is:

80 SHARRON AVE
PLATTSBURGH, NY
ZIP 12901-700
Phone: (518) 561-1447
Fax: (518) 562-8812

The provider's authorized official is Tammy Smith .
The authorized official title is Director, Op Billing Dept. and has the following contact phone number (518) 952-8408.

The CLIA number assigned to this NPI record is 33D2028445 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 4/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01420800	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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