Provider Demographics
NPI:1750513685
Name:LEXINGTON CENTER FOR RECOVERY
Entity type:Organization
Organization Name:LEXINGTON CENTER FOR RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:CUTCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:845-486-8880
Mailing Address - Street 1:20 MANCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603
Mailing Address - Country:US
Mailing Address - Phone:845-486-2950
Mailing Address - Fax:845-486-2999
Practice Address - Street 1:20 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2412
Practice Address - Country:US
Practice Address - Phone:845-486-2950
Practice Address - Fax:845-486-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078568251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare