NPIMap

Organization Active NPI

Council on Addiction Recovery Services Inc

Doing business as Wendy's House Supportive Living

  • Substance Abuse Rehabilitation Facility
  • Olean, NY
National Provider Identifier
1245645324
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
150910172 Issued in NY
Legal business name
COUNCIL ON ADDICTION RECOVERY SERVICES INC
Doing business as
Wendy's House Supportive Living
Practice address
201 S Union St
Olean, NY 14760-3646
Phone
(716) 373-4303
Fax
(716) 373-4327
NPI assigned
Jun 26, 2014
Last updated
Aug 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNCIL ON ADDICTION RECOVERY SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael H Prutsman, CPP, MA
Title
Executive Director
Phone
(716) 373-4303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 150910172 NY Primary

Addresses

Primary practice location

201 S Union St
Olean, NY 14760-3646

Mailing address

201 S Union St
PO Box 567
Olean, NY 14760-3646
Phone (716) 373-4303

Other identifiers 5

IdentifierTypeStateIssuer
00933817MedicaidNY
030770OtherNYNYS CHARITIES REGISTRATION
170809255OtherNYDUNS AND BRADSTREET
38160OtherNYOASAS
000000816000OtherNYBLUE CROSS

Other names 1

  • Wendy's House Supportive Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Council on Addiction Recovery Services Inc4 organizations share this tax ID, including this one
Part of
Council on Addiction Recovery Services Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

201 S Union St
Olean, NY 14760
Phone (716) 373-4303

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1245645324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S UNION ST",
            "address_2": "PO BOX 567",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147603646",
            "telephone_number": "716-373-4303",
            "fax_number": "716-373-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S UNION ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147603646",
            "telephone_number": "716-373-4303",
            "fax_number": "716-373-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL ON ADDICTION RECOVERY SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNCIL ON ADDICTION RECOVERY SERVICES, INC.",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "PRUTSMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-373-4303",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPP, MA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "150910172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00933817",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS CHARITIES REGISTRATION",
            "identifier": "030770",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUNS AND BRADSTREET",
            "identifier": "170809255",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OASAS",
            "identifier": "38160",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000816000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wendy's House Supportive Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.