Provider First Line Business Practice Location Address:
230 NORTH ROAD
Provider Second Line Business Practice Location Address:
LEXINGTON CENTER FOR RECOVERY MMTP
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-486-2850
Provider Business Practice Location Address Fax Number:
845-486-2770
Provider Enumeration Date:
06/25/2007