Stanley Long DBA Harbor Lights Professional Chemical Dependency Servic

NPI #1164435244 in Mexico, New York

Provider Information

NPI Number: 1164435244
Entity Type: Organization
Organization Name: Stanley Long DBA Harbor Lights Professional Chemical Dependency Servic
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Aug 13, 2006
Last Updated: Jul 17, 2008

Practice Location

Address: 3358 MAIN ST
City: Mexico
State: New York
ZIP Code: 13114
Phone: (315) 963-0777

Authorized Official

Name: MR. STANLEY E LONG
Title: OWNER
Phone: (315) 963-0777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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