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DICK VAN DYKE ADDICTION TREATMENT CENTER
NPI 1730274937
Community/Behavioral Health in Ovid, NY

Active since October 04, 2006CLIA 33D2040194 · Waiver
1330 COUNTY ROAD 132, OVID, NY 14521(607) 869-9500(607) 869-5303 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dick Van Dyke Addiction Treatment Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DICK VAN DYKE ADDICTION TREATMENT CENTER (NPI 1730274937) is a healthcare organization registered as a community/behavioral health in Ovid, New York and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Michael A Lawler, Associate Commissioner Division Of, as its authorized official.

NPPES Registry Identity

NPI1730274937
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameDICK VAN DYKE ADDICTION TREATMENT CENTER
Location Address1330 COUNTY ROAD 132Ovid, NY 14521
Mailing Address1330 County Road 132Ovid, NY 14521 · (607) 869-9500 · Fax (607) 869-5303
Phone(607) 869-9500
Fax(607) 869-5303
Organization SubpartNo
Authorized OfficialMichael A LawlerAssociate Commissioner Division Of · (518) 457-5312
Enumeration DateOctober 4, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1730274937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

1330 COUNTY ROAD 132, Ovid, NY 14521
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2040194

Dick Van Dyke Addiction Treatment Center · Willard, NY
Active · expires Mar 26, 2027
CLIA Number33D2040194
Laboratory TypeAddiction Treatment
Certificate Effective DateApril 25, 2012
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Abdelkader Mallouk
Laboratory Phone(315) 835-6136
Laboratory LocationDick Van Dyke Addiction Treatment Center7116 County Road 132 - Bldg 112, Willard, NY 14588
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORIE ANN NELLENBACK PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1330 COUNTY ROAD 132
OVID, NY 14521
Seneca County (315) 835-6136
MRS. DONNA ANNE CERZA FNP-C
Legal Medicine
1330 COUNTY ROAD 132
OVID, NY 14521
Seneca County (607) 869-5609

Frequently Asked Questions

What is DICK VAN DYKE ADDICTION TREATMENT CENTER's NPI number?

The NPI number assigned to this healthcare provider is 1730274937, enumerated as an "organization" on October 04, 2006.

Where is the provider located?

The provider is located at 1330 COUNTY ROAD 132 OVID, NY 14521 and the phone number is (607) 869-9500.

What is the provider's specialty?

Community/Behavioral Health with taxonomy code 251S00000X.