Organization · Type 2 NPI
Independent Group Home Living
Intellectual Disabilities Intermediate Care Facility · Eastport, NY
NPI number
1710150289
Active
Practice location
240 Old Country Rd
Eastport, NY 11941
Fax (631) 878-8201
Mailing address
221 N Sunrise Service Rd
Manorville, NY 11949-9604
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
Other intellectual disabilities intermediate care facility providers in Eastport
About NPI 1710150289
Independent Group Home Living's National Provider Identifier is 1710150289, issued on Apr 7, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Eastport, NY. The record was last updated on Apr 7, 2008.