Organization · Type 2 NPI
Independent Group Home Living
Intellectual Disabilities Intermediate Care Facility · East Quogue, NY
NPI number
1801069364
Active
Practice location
135 Old Country Rd
East Quogue, NY 11942
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.
About NPI 1801069364
Independent Group Home Living's National Provider Identifier is 1801069364, issued on Apr 7, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in East Quogue, NY. The record was last updated on Apr 7, 2008.