Organization · Type 2 NPI
Independent Group Home Living
Intellectual Disabilities Intermediate Care Facility · Nesconset, NY
NPI number
1992978456
Active
Practice location
200 A Gibbs Pond Rd
Nesconset, NY 11767
Fax (631) 878-8201
Mailing address
221 N Sunrise Service Rd
Manorville, NY 11949-9604
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | None listed |
| 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 1992978456
Independent Group Home Living's National Provider Identifier is 1992978456, issued on Apr 7, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Nesconset, NY. The record was last updated on Apr 7, 2008.