Provider Demographics
NPI:1679785273
Name:CITIZEN ADVOCATES, INC
Entity Type:Organization
Organization Name:CITIZEN ADVOCATES, INC
Other - Org Name:CLINIC OASAS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:I
Authorized Official - Last Name:LANGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-483-1251
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:209 PARK STREET
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-0608
Mailing Address - Country:US
Mailing Address - Phone:518-483-1251
Mailing Address - Fax:518-483-2242
Practice Address - Street 1:209 PARK STREET
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-0608
Practice Address - Country:US
Practice Address - Phone:518-483-1251
Practice Address - Fax:518-483-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7533100A261QD1600X, 261QM0801X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01111260Medicaid