CRYSTAL RUN VILLAGE


Address: 601 Stony Ford Rd, Middletown, NY 10941-3951
Phone: 8456924444

CRYSTAL RUN VILLAGE (NPI# 1619123999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619123999
Entity Type Organization
Organization Name CRYSTAL RUN VILLAGE
Practice Address 601 Stony Ford Rd
Middletown
NY 10941-3951
Practice Telephone 8456924444
Practice Fax Number 8456951101
Mailing Telephone 8456924444
Mailing Fax Number 8456951101
Enumeration Date 2008-08-18
Last Update Date 2008-08-26
Authorized Official Name MR. WILLIAM SAMMIS (DEPUTY ED OF ADMIN SERVICES)
Authorized Official Telephone 8456952559
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3104A0625X Assisted Living Facility
Specialization: Assisted Living, Mental Illness
Nursing & Custodial Care Facilities

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities CRYSTAL RUN VILLAGE 601 Stony Ford Rd, Middletown, NY 10941-3951

Office Location

Street Address 601 STONY FORD RD
City MIDDLETOWN
State NY
Zip Code 10941-3951

Providers in the same location

NPI Name Taxonomy Address Enumeration
1386778546 Crystal Run Village, Inc Intermediate Care Facility, Mentally Retarded 601 Stony Ford Rd, Middletown, NY 10941-3951 2007-03-16
1134407760 Crystal Run Village, Inc. Case Management 601 Stony Ford Rd, Middletown, NY 10941-3951 2011-08-01
1619149077 Crystal Run Village Inc Intermediate Care Facility, Mentally Retarded 601 Stony Ford Rd, Middletown, NY 10941-3951 2008-03-26
1619149069 Crystal Run Village Inc Intermediate Care Facility, Mentally Retarded 601 Stony Ford Rd, Middletown, NY 10941-3951 2008-03-26
1083831036 Crystal Run Village, Inc Day Training, Developmentally Disabled Services 601 Stony Ford Rd, Middletown, NY 10941 2007-04-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407471428 Jackeline Montoya Case Manager/Care Coordinator 13 Kensington Manor, Middletown, NY 10941 2020-06-15
1124502398 Kimberly Dominique Mccormick Licensed Practical Nurse 29, Macintosh Drive, Middletown, NY 10941 2018-09-24
1750891081 Heather Skinner Case Manager/Care Coordinator 75 Crystal Run Rd Suite 201, Middletown, NY 10941 2017-09-29
1295281012 Christa Lloyd Counselor 15 Fortune Rd, West Middletown, NY 10941 2016-08-31
1023471109 Lauren Battaglia Occupational Therapy Assistant 192 Tower Drive Suite 400, Middletown, NY 10941 2016-04-05
1992188718 Brynn Sierra Occupational Therapist 21 Riverside Drive, Middletown, NY 10941 2015-06-30
1356788574 Keren Denis Joseph Custodial Care Facility 16 Disco Dr, Middletown, NY 10941 2013-05-29
1902169204 Susan A. Reilly Specialist 2277 Gosen Turnpike, Middletown, NY 10941 2012-06-21
1518229392 Dena Sapp Case Manager/Care Coordinator 75 Crystal Run Rd. Suite 201, Middletown, NY 10941 2012-06-08
1770800542 Orange County Medical Transportation Inc. Taxi 80 Wisner Avenue, Middletown, NY 10941 2010-05-03
Find all providers in zip 10941

Taxonomy Information

Taxonomy Code 3104A0625X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility
Specialization Assisted Living, Mental Illness

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578911921 Leroy Manor Assisted Living Facility 8678 Lake Street Road, Leroy, NY 14482 2016-05-26
1043679384 Blakes Income Tax Services Assisted Living Facility 4509 White Plains Road, Bronx, NY 10470 2016-02-15
1578909594 Tanis Phillips Assisted Living Facility 98 Cathedral Ln, Cheektowaga, NY 14225-4612 2013-05-16
1770783813 Loretto Geriatric Community Residence Assisted Living Facility 750 E Brighton Ave, Syracuse, NY 13205-2201 2007-07-18
1861526055 Ohel Children's Home &family Services Assisted Living Facility 1217 Gateway Blvd, Far Rockaway, NY 11691 2007-03-16
1407913619 Capital District Psychiatric Center Assisted Living Facility 75 New Scotland Ave, Albany, NY 12208-3409 2007-01-03
1407911928 Middletown Psychiatric Center Assisted Living Facility 140 Old Orangeberg Rd, Orangeberg, NY 10962 2006-12-26
1588033609 Nys Office of Mental Health Assisted Living Facility 140 Old Orangeburg Rd, Orangeburg, NY 10962-1157 2015-09-18
1487057972 Mary Agnes Manor Assisted Living Facility 307 Porter Ave, Buffalo, NY 14201-1031 2014-09-29
1740683226 Heritage Manor of Ransomville Assisted Living Facility 3509 Ransomville Rd, Ransomville, NY 14131-9602 2014-09-29
Find all providers with the same taxonomy

Competitor

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City MIDDLETOWN
Zip Code 10941

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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