Hazelden New York

NPI #1053605923 in New York, New York

Provider Information

NPI Number: 1053605923
Entity Type: Organization
Organization Name: Hazelden New York
Subpart: Yes (part of a larger organization)
Parent Organization: HAZELDEN NEW YORK
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Jun 8, 2011
Last Updated: May 16, 2025

Practice Location

Address: 283 W BROADWAY
City: New York
State: New York
ZIP Code: 10013-2204
Phone: (800) 257-7800

Authorized Official

Name: ASHLEY GIBSON
Title: VP PAYER RELATIONS
Phone: (651) 213-4519

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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