Conifer Park, Inc.

LBN: Conifer Park, Inc.
Conifer Park, Inc. is an health care organization with primary practice located at 79 Glenridge Rd Cottage #1, Glenville NY 12302-4523. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty. Conifer Park, Inc. can be contacted via phone (518) 952-8121, or through Smith, Tammy via phone (518) 952-8408.

Contact Information

Primary practice address
79 Glenridge Rd Cottage #1 Glenville NY 12302-4523
Phone: (518) 952-8121
Fax: (518) 952-8287
Website:
Map and Directions
Authorized official contact:
Name: Smith, Tammy
Phone: (518) 952-8408

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 081110730 New York

Profile Details

NPI number 1336339969
LBN Legal business name Conifer Park, Inc.
DBA Doing business as
Authorized official Smith, Tammy
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2007
Last updated Dec 23rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336339969 NPPES
New York MEDICAID 01420800

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