INDEPENDENT GROUP HOME LIVING (NPI# 1629241187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629241187 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT GROUP HOME LIVING |
| Practice Address |
44 Woodland Ave Manorville NY 11949-9604 |
| Mailing Address |
221 N Sunrise Service Rd Manorville NY 11949-9604 |
| Practice Telephone | 6318788900 |
| Practice Fax Number | 6318788201 |
| Mailing Telephone | 6318788900 |
| Mailing Fax Number | 6318788201 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |
| Authorized Official Name | MR. WALTER W. STOCKTON (C.E.O.) |
| Authorized Official Telephone | 6318788900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities | ||
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00728890 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174796635 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 65 Pine St, East Moriches, NY 11940 | 2008-04-07 |
| 1356514814 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 120 Frowein Rd, East Moriches, NY 11940 | 2008-04-07 |
| 1275706731 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 125 Sebonic Rd, South Hampton, NY 11955 | 2008-04-07 |
| 1457524910 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 133 Shore Rd W, Mount Sinai, NY 11766-1237 | 2008-04-07 |
| 1366615825 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 864 Pleasure Dr, Flanders, NY 11901 | 2008-04-07 |
| 1629241195 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 288 Chapman Blvd, Manorville, NY 11949-3125 | 2008-04-07 |
| 1538332093 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 651 Longwood Rd., Middle Island, NY 11954 | 2008-04-07 |
| 1801069372 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 114 N Phillips Ave, Speonk, NY 11972 | 2008-04-07 |
| 1801069364 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 135 Old Country Rd, East Quogue, NY 11942 | 2008-04-07 |
| 1710150271 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 21 Montauk Highway, Center Moriches, NY 11934 | 2008-04-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | INDEPENDENT GROUP HOME LIVING PROGRAM FOUNDATION | 221 North Sunrise Service Rd., Manorville, New York 11949 |
| New York State Corporations | INDEPENDENT GROUP HOME LIVING PROGRAM, INC. | 221 North Sunrise Service Rd., Manorville, Ny 11949 |
| Street Address |
44 WOODLAND AVE |
| City | MANORVILLE |
| State | NY |
| Zip Code | 11949-9604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992270946 | Bethesda Elite Care Inc | Home Health | 3 Surrey Lane, Manorville, NY 11949 | 2018-10-05 |
| 1922303072 | Samantha Ann Martino | Licensed Practical Nurse | 20 North Street, Manorville, NY 11949 | 2011-01-21 |
| 1336449453 | Eastport South Manor School District | Local Education Agency (LEA) | 543 Moriches Middle Island Rd, Manorville, NY 11949 | 2010-10-22 |
| 1134439599 | Lori M. Franchi | Social Worker | 543 Moriches Middle Island Road, Manorville, NY 11949 | 2010-10-19 |
| 1952556706 | Dawn Marie Munoz | Developmental Therapist | 53 Manorview Way, Manorville, NY 11949 | 2008-11-20 |
| 1770704504 | Ka Lun Benny Chan | Pharmacist | 8 Long Road, Manorville, NY 11949 | 2007-05-01 |
| 1245374560 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 226 Eastport Manor Road, Manorville, NY 11949 | 2007-02-19 |
| 1891865721 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 221 N. Sunrise Service Rd., Manorville, NY 11949 | 2006-11-08 |
| 1639107451 | Robert Galler | Neurological Surgery | 496 County Road 111, Building D, Manorville, NY 11949 | 2006-06-29 |
| 1679981401 | Elizabeth Ann Sanders | Physician Assistant | 496 County Road 111, Building B, Manorville, NY 11949 | 2014-07-24 |
| Find all providers in zip 11949 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629241195 | Independent Group Home Living | Intermediate Care Facility, Mentally Retarded | 288 Chapman Blvd, Manorville, NY 11949-3125 | 2008-04-07 |
| 1245374560 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 226 Eastport Manor Road, Manorville, NY 11949 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762665 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 260 W 8th St, Elmira Heights, NY 14903-1502 | 2020-05-21 |
| 1518580851 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 525 Liberty St, Elmira, NY 14904-1517 | 2020-05-21 |
| 1386276541 | United Cerebral Palsy of Nyc Inc | Intermediate Care Facility, Mentally Retarded | 1841-1845 Lacombe Ave, Bronx, NY 10472 | 2020-02-06 |
| 1003447012 | State of New York | Intermediate Care Facility, Mentally Retarded | 8045 Winchester Blvd Bldg 08, Queens Village, NY 11427-2194 | 2020-01-29 |
| 1427696061 | Elderberry Icf | Intermediate Care Facility, Mentally Retarded | 15 Poem Place, Monticello, NY 12701 | 2019-12-13 |
| 1538666052 | Upstate Cerebral Palsy, Inc. | Intermediate Care Facility, Mentally Retarded | 95 Seymour Lane, Westmoreland, NY 13490 | 2018-04-11 |
| 1457857716 | Nysarc, Inc. Cattaraugus-niagara County Chapter | Intermediate Care Facility, Mentally Retarded | 6821 Saunders Settlement Rd, Sanborn, NY 14132-9440 | 2018-04-04 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1962959403 | Linda Burgess | Intermediate Care Facility, Mentally Retarded | 35 E 8th Ave, Gloversville, NY 12078-2229 | 2016-09-01 |
| 1154774727 | Birch Family Services, Inc. | Intermediate Care Facility, Mentally Retarded | 525 W 149th St, New York, NY 10031-3402 | 2016-07-19 |
| Find all providers with the same taxonomy | ||||
| City | MANORVILLE |
| Zip Code | 11949 |
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| 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.