CONIFER PARK, INC. (NPI# 1366632986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366632986 |
| Entity Type | Organization |
| Organization Name | CONIFER PARK, INC. |
| Practice Address |
216 Main St Suite #2 Hudson Falls NY 12839-1813 |
| Mailing Address |
Po Box 417153 Boston MA 02241-7153 |
| Practice Telephone | 5187937273 |
| Practice Fax Number | 5187985004 |
| Mailing Telephone | 5189528140 |
| Mailing Fax Number | 5189528287 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2013-03-26 |
| Authorized Official Name | BARBARA A PETTEYS (DIRECTOR, OP BILLING) |
| Authorized Official Telephone | 5189528140 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
070810729 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01420800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730379504 | Conifer Park, Inc. | Clinic/Center | 323 Lake Hill Road, Hawley Cottage, 1st Floor, Burnt Hills, NY 12027-9772 | 2007-07-27 |
| 1346296720 | Conifer Park, Inc. | Clinic/Center | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2006-05-26 |
| 1235185612 | Conifer Park, Inc. | Clinic/Center | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2006-05-26 |
| 1366498768 | Conifer Park, Inc. | Clinic/Center | 526 Old Liverpool Rd, Liverpool, NY 13088-6238 | 2006-05-26 |
| 1972558179 | Conifer Park, Inc. | Clinic/Center | 55 Elm St, Glens Falls, NY 12801-3549 | 2006-05-24 |
| 1356396543 | Conifer Park, Inc. | Clinic/Center | 2435 6th Ave, Troy, NY 12180-2227 | 2006-05-24 |
| 1154652709 | Conifer Park, Inc. | Substance Abuse Rehabilitation Facility | 15 Henning Rd, F. Donald Myers Education Center, Saratoga Springs, NY 12866-3749 | 2010-01-21 |
| 1336339969 | Conifer Park, Inc. | Clinic/Center | 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 | 2007-07-30 |
| 1023208139 | Conifer Park, Inc. | Clinic/Center | 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 | 2007-07-26 |
| 1649225897 | Conifer Park, Inc. | Clinic/Center | 600 Franklin St, Schenectady, NY 12305-2100 | 2006-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CONIFER PARK, INC. | 79 Glenridge Road, Glenridge, Ny 12302 |
| Street Address |
216 MAIN ST SUITE #2 |
| City | HUDSON FALLS |
| State | NY |
| Zip Code | 12839-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555814 | Marissa Whiting | Social Worker | 3043 Us 4, Hudson Falls, NY 12839 | 2020-10-16 |
| 1598381568 | Alli Jennifer Clark | Social Worker | 15 Boulevard, Hudson Falls, NY 12839 | 2020-06-24 |
| 1720614399 | Rebecca Lynn Leclaire | Registered Nurse | 1051 Dix Avenue, Hudson Falls, NY 12839 | 2020-03-16 |
| 1902444821 | Sydney Dwinell Ayotte | Social Worker | 3043 Us Route 4, Hudson Falls, NY 12839 | 2019-12-11 |
| 1013572809 | Dme Consulting Agency LLC | Durable Medical Equipment & Medical Supplies | 146 River Street, Hudson Falls, NY 12839 | 2019-05-07 |
| 1487165296 | Jessica Percetti | Registered Nurse | 80 E Labarge Street, Hudson Falls, NY 12839 | 2017-10-19 |
| 1811443575 | Misty Jane Lacross | Registered Nurse | 80 East Labarge Street, Hudson Falls, NY 12839 | 2016-08-31 |
| 1851709042 | Danielle Marie Tortorici | Physician Assistant | 340a Main Street, Hudson Falls, NY 12839 | 2014-07-31 |
| 1538464862 | Maria C Luciani | Social Worker | 15 Bouelvard Street, Hudson Falls, NY 12839 | 2011-01-18 |
| 1811218837 | Michelle L Burke | Registered Nurse | 80 E. Labarge St., Hudson Falls, NY 12839 | 2010-06-14 |
| Find all providers in zip 12839 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023208139 | Conifer Park, Inc. | Clinic/Center | 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 | 2007-07-26 |
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| 1760831119 | Vasuli Inc | Clinic/Center | 325 W 45th St, 812, New York, NY 10036-4191 | 2016-06-07 |
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| 1588066716 | Care Counseling Center, LLC | Clinic/Center | 214 W 116th St, New York, NY 10026-2494 | 2014-09-18 |
| 1831507573 | Nathaniel Chambers | Clinic/Center | 801 Saint Anns Ave, Bronx, NY 10456-7648 | 2014-07-25 |
| 1508272238 | Trinity of Chemung County | Clinic/Center | 150 Lake St Ste 2, Elmira, NY 14901-3401 | 2014-07-02 |
| 1093074825 | Community Counseling & Mediation | Clinic/Center | 367 E 7th St, Brooklyn, NY 11218-4105 | 2012-05-14 |
| Find all providers with the same taxonomy | ||||
| City | HUDSON FALLS |
| Zip Code | 12839 |
Please comment or provide details below to improve the information on CONIFER PARK, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.