Provider Demographics
NPI:1225180052
Name:CHILD AND ADOLESCENT TREATMENT SERVICES INC
Entity Type:Organization
Organization Name:CHILD AND ADOLESCENT TREATMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW ACSW
Authorized Official - Phone:716-819-3420
Mailing Address - Street 1:301 CAYUGA ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1950
Mailing Address - Country:US
Mailing Address - Phone:716-819-3420
Mailing Address - Fax:719-819-3430
Practice Address - Street 1:3350 MAIN STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-835-4011
Practice Address - Fax:716-835-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00357855Medicaid