Provider Demographics
NPI:1831284819
Name:ONTARIO COUNTY SUBSTANCE ABUSE SERVICES
Entity Type:Organization
Organization Name:ONTARIO COUNTY SUBSTANCE ABUSE SERVICES
Other - Org Name:TURNINGS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CASAC
Authorized Official - Phone:585-396-4190
Mailing Address - Street 1:3019 COUNTY COMPLEX DRIVE
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9884
Mailing Address - Country:US
Mailing Address - Phone:585-396-4190
Mailing Address - Fax:585-393-2916
Practice Address - Street 1:3019 COUNTY COMPLEX DRIVE
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9884
Practice Address - Country:US
Practice Address - Phone:585-396-4190
Practice Address - Fax:585-393-2916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061110915261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY166002535Medicaid