Provider Demographics
NPI:1235110404
Name:INSIGHT HOUSE CHEMICAL DEPENDENCY SERVICES INC
Entity Type:Organization
Organization Name:INSIGHT HOUSE CHEMICAL DEPENDENCY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-724-5168
Mailing Address - Street 1:500 WHITESBORO ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3015
Mailing Address - Country:US
Mailing Address - Phone:315-724-5168
Mailing Address - Fax:315-724-6582
Practice Address - Street 1:500 WHITESBORO ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3015
Practice Address - Country:US
Practice Address - Phone:315-724-5168
Practice Address - Fax:315-724-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080610624251K00000X
NY080610076251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare