Listing of Certified Chemical Dependence Treatment Providers As of September 21, 2021 Division of Quality Assurance and Performance Improvement Bureau of Certification Janet L. Paloski, Director, Bureau of Certification 820 River St., Inc. Provider Number: 35210 Mr. Peter Newkirk, Chief Executive Officer Telephone - (518)-377-4228 Ext 202 Administrative Office: 428 Duane Avenue, Schenectady, NY 12304 Certificate Number: 181210136 Special ReIssue Effective: 01/01/2018 Anticipated Recert Review: 12/31/2018 Program Location: 111-113 Second Avenue, , Troy, New York 12180 Service Type: Supportive Living (819) PRU: 50863 Certified Capacity: 14 Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10136_820Riv.pdf Certificate Number: 201110640 Conditional Certificate Effective: 08/31/2020 Anticipated Recert Review: 11/30/2020 Program Location: 134 Franklin Street, Albany, New York 12202 Service Type: Outpatient Service (822) PRU: 51423 Certified Capacity: with Telepractice Designation Program Name: Eleanor R. Young Memorial Clinic Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10640_820Riv.pdf Certificate Number: 181211470 Special ReIssue Effective: 01/01/2018 Anticipated Recert Review: 12/31/2018 Program Location: 9-10 Saint Joseph's Terrace, Albany, New York 12210 Service Type: Supportive Living (819) PRU: 51903 Certified Capacity: 15 for women. Program Name: Eleanor Young Residence Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11470_820Riv.pdf Certificate Number: 220111575 Renewal Effective: 02/01/2020 Anticipated Recert Review: 1/31/2022 Program Location: 551 Bay Road, Queensbury, New York 12804 Service Type: Outpatient Service (822) PRU: 52105 Certified Capacity: with Telepractice Designation Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11575_820Riv.pdf Certificate Number: 200612187 Establishment Effective: 07/22/2019 Anticipated Recert Review: 6/30/2020 Program Location: 13 Crandall Street, , Glens Falls, New York 12801 Service Type: Residential Services (820) PRU: 53339 Certified Capacity: 21 for men Elements: Stabilization Rehabilitation Reintegration Congregate Scattered Program Name: Crandall St. Reintegration Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/12187_820Riv.pdf September 21, 2021 Page 1 of 225 A.R.E.B.A. - Casriel, Inc. d/b/a Addiction Care Interventions Provider Number: 11490 Ms. Hawa U. Jalloh MSW CASAC, Chief Executive Telephone - (929)-258-0059 Ext 1002 Administrative Office: Officer 589 Rockaway Avenue, Brooklyn, NY 11212 Certificate Number: 211210643 Establishment Effective: 01/29/2021 Anticipated Recert Review: 12/31/2021 Program Location: 8th Floor, 255 West 36th Street, , New York, New York 10018 Service Type: Outpatient Service (822) PRU: 3489 Certified Capacity: with Telepractice Designation [with ancillary withdrawal services] Program Name: Alcoholism Treatment Center Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10643_AREBAC.pdf Certificate Number: 211211439 Amendment Effective: 04/01/2021 Anticipated Recert Review: 12/31/2021 Program Location: Pharmacy - 1st Floor, Floors 1-4, 589 Rockaway Avenue, , Brooklyn, New York 11212 Service Type: Medically Supervised Inpatient Withdrawal & Stabilization Services (816.7) PRU: 51656 Certified Capacity: 135 with Telepractice Designation (w/ability to swing 45 beds between Medically Supervised Inpatient Withdrawal and Inpatient Rehab. services with the use of methadone) Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11439_AREBAC.pdf Certificate Number: 211211447 Amendment Effective: 04/01/2021 Anticipated Recert Review: 12/31/2021 Program Location: Floors 3-5, 589 Rockaway Avenue, , Brooklyn, New York 11212 Service Type: Inpatient Rehabilitation Service ( 818) PRU: 51389 Certified Capacity: 46 with Telepractice Designation Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11447_AREBAC.pdf AAA Health, Inc. Provider Number: 43710 Ms. Alla Papush, Administrator Telephone - (718)-421-2101 Administrative Office: 1090 Coney Island Ave., Brooklyn, NY 11230 Certificate Number: 221011468 Amendment Effective: 10/02/2020 Anticipated Recert Review: 10/31/2022 Program Location: 2nd Floor, 1090 Coney Island Avenue, Brooklyn, New York 11230 Service Type: Outpatient Service (822) PRU: 51953 Certified Capacity: with Telepractice Designation [with ancillary withdrawal services] Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11468_AAAHea.pdf Acacia Network, Inc. as Sponsor El Regreso, Inc. as Operator Provider Number: 1522 Mr. Raul Russi, Chief Executive Officer Telephone - (347)-649-3295 Administrative Office: 141-143 South 3rd Street, Brooklyn, NY 11211 September 21, 2021 Page 2 of 225 Certificate Number: 190210021 Establishment Effective: 03/12/2018 Anticipated Recert Review: 2/28/2019 Program Location: 834 East 156th Street, Bronx, New York 10455 Service Type: Intensive Residential Rehabilitation (819) PRU: 6093 Certified Capacity: 54 for men. Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10021_Acacia.pdf Certificate Number: 190211487 Establishment Effective: 03/12/2018 Anticipated Recert Review: 2/28/2019 Program Location: 141-143 South Third Street, Brooklyn, New York 11211 Service Type: Intensive Residential Rehabilitation (819) PRU: 51995 Certified Capacity: 40 for women. Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11487_Acacia.pdf Certificate Number: 220211511 Conditional Certificate Effective: 08/01/2021 Anticipated Recert Review: 2/28/2022 Program Location: 141-143 South 3rd Street, Brooklyn, New York 11211 Service Type: Outpatient Service (822) PRU: 6321 Certified Capacity: with Telepractice Designation Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/11511_Acacia.pdf Acacia Network, Inc. as Sponsor Greenhope Services for Women, Inc. as Operator Provider Number: 31030 Mr Raul Russi, CEO Telephone - (347)-649-3036 Administrative Office: 6th Floor, 300 E. 175th Street, Bronx, NY 10457 Certificate Number: 240212196 Renewal Effective: 03/01/2021 Anticipated Recert Review: 2/29/2024 Program Location: Basement & Floors 1-8, 435-439 East 119th Street, , New York, New York 10035 Service Type: Residential Services (820) PRU: 53353 Certified Capacity: 72 and up to 14 beds for children Elements: Stabilization Rehabilitation Reintegration Congregate Scattered Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/12196_Acacia.pdf Acacia Network, Inc. as Sponsor, United Bronx Parents, Inc. as Operator Provider Number: 330 Mr. Raul Russi, Chief Executive Officer Telephone - (347)-649-3036 Administrative Office: 966 Prospect Avenue, Bronx, NY 10459 Certificate Number: 181210107 Amendment Effective: 06/19/2018 Anticipated Recert Review: 12/31/2018 Program Location: 773 Prospect Avenue, Bronx, New York 10455 Service Type: Intensive Residential Rehabilitation (819) PRU: 5750 Certified Capacity: 38 and up to 51 beds for children Program Name: Lorraine Montenegro Women and Children's Facility Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10107_Acacia.pdf September 21, 2021 Page 3 of 225 Certificate Number: 181210553 Special ReIssue Effective: 01/01/2018 Anticipated Recert Review: 12/31/2018 Program Location: 1st-4th Floors, 1006 East 151st Street, Bronx, New York 10455 Service Type: Intensive Residential Rehabilitation (819) PRU: 7258 Certified Capacity: 21 and up to 44 beds for children Program Name: La Casita III - The Mix Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10553_Acacia.pdf Acacia Network, Inc. as Sponsor, Bronx Addiction Services Integrated Concepts System, Inc. as Operator Provider Number: 1857 Mr. Raul Russi, Chief Executive Officer Telephone - (347)-649-3036 Administrative Office: 6th floor, 300 East 175th Street, Bronx, NY 10457 Certificate Number: 240112165 Renewal Effective: 02/01/2021 Anticipated Recert Review: 1/31/2024 Program Location: [Sleeping Purposes Only for 15 beds at], 4th & 5th Floors, [Services Provided at], 1068 Franklin Avenue, 1064 Franklin Avenue, Bronx, New York 10456 Service Type: Residential Services (820) PRU: 53297 Certified Capacity: 130 Elements: Stabilization Rehabilitation Reintegration Congregate Scattered Program Name: Franklin House Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/12165_Acacia.pdf Acacia Network, Inc. as Sponsor, Queens Village Committee for Mental Health for Jamaica Community Adolesc Provider Number: 31340 Mr. Raul Russi, President & CEO Telephone - 347-649-3037 Administrative Office: 300 East 175th Street, Bronx, NY 11434 Certificate Number: 220210090 Establishment Effective: 03/19/2021 Anticipated Recert Review: 2/28/2022 Program Location: 116-30 Sutphin Boulevard, Jamaica, New York 11434 Service Type: Intensive Residential Rehabilitation (819) PRU: 1256 Certified Capacity: 192 Program Name: Compliance Performance Data: http://webapps.oasas.ny.gov/legal/CertApp/Directory/documents/10090_Queens.pdf Acacia Network,