NPIMap

Organization Active NPI

City Gate Life Recovery Center, Inc.

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1285108746
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CITY GATE LIFE RECOVERY CENTER, INC.
Practice address
610 Ashland Ave
Buffalo, NY 14222-1309
Phone
(716) 510-5801
NPI assigned
Jan 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Carol ConklinNPI 1558338608
Title
Owner
Phone
(716) 883-7713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

610 Ashland Ave
Buffalo, NY 14222-1309

Mailing address

610 Ashland Ave
Buffalo, NY 14222-1309
Phone (716) 510-5801

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1285108746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ASHLAND AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221309",
            "telephone_number": "716-510-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ASHLAND AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221309",
            "telephone_number": "716-510-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY GATE LIFE RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-883-7713"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.