Provider Demographics
NPI:1356074447
Name:COMMUNITY AWARENESS NETWORK FOR A DRUGFREE LIFE AND ENVIRONMENT INC
Entity Type:Organization
Organization Name:COMMUNITY AWARENESS NETWORK FOR A DRUGFREE LIFE AND ENVIRONMENT INC
Other - Org Name:CLARKSTOWN AWARENESS NETWORK FOR A DRUG FREE LIFE AND ENVIRONMENT, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:845-634-6677
Mailing Address - Street 1:120 N MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3743
Mailing Address - Country:US
Mailing Address - Phone:845-634-6677
Mailing Address - Fax:845-307-6607
Practice Address - Street 1:120 N MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3743
Practice Address - Country:US
Practice Address - Phone:845-634-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)