Provider Demographics
NPI:1073055802
Name:LEXINGTON CENTER FOR RECOVERY
Entity Type:Organization
Organization Name:LEXINGTON CENTER FOR RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:OMARO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-235-6633
Mailing Address - Street 1:373 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1821
Mailing Address - Country:US
Mailing Address - Phone:914-395-1955
Mailing Address - Fax:
Practice Address - Street 1:3 COTTAGE PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4201
Practice Address - Country:US
Practice Address - Phone:914-235-6633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health