INDEPENDENT GROUP HOME LIVING (NPI# 1710150271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710150271 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT GROUP HOME LIVING |
| Practice Address |
21 Montauk Highway Center Moriches NY 11934 |
| Mailing Address |
221 N Sunrise Service Rd Manorville NY 11949-9604 |
| Practice Telephone | 6318788900 |
| Practice Fax Number | 6318788900 |
| Mailing Telephone | 6318788900 |
| Mailing Fax Number | 6318788900 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |
| Authorized Official Name | MR. WALTER W. STOCKTON (CHIEF EXECUTIVE OFFICER) |
| 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 | 00575159 | 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 |
| 1629241187 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 44 Woodland Ave, Manorville, NY 11949-9604 | 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 |
| 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 |
21 MONTAUK HIGHWAY |
| City | CENTER MORICHES |
| State | NY |
| Zip Code | 11934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275915381 | Julie Stuart | Licensed Practical Nurse | 43 Railroad Ave, Center Moriches, NY 11934 | 2015-06-25 |
| 1932508520 | Christopher Gene Doloroso | Social Worker | 408 Main Street #3, Center Moriches, NY 11934 | 2014-08-19 |
| 1710236211 | Jeannine Casper | Behavioral Analyst | 20 Senix Avenue, Center Moriches, NY 11934 | 2012-08-30 |
| 1255600243 | Ellen Stein | Counselor | 129 Hewitt Blvd., Center Moriches, NY 11934 | 2011-12-20 |
| 1295035491 | Philip Henry Antz | Social Worker | 220 Mainstreet, Center Moriches, NY 11934 | 2010-10-22 |
| 1215169602 | Holly Lee Gordon | Social Worker | 408 Main St South, Center Moriches, NY 11934 | 2009-08-18 |
| 1740415744 | Sleep Disorder Center | Internal Medicine | 356 Maind St, Center Moriches, NY 11934 | 2009-05-19 |
| 1033358957 | Louise Florence Colon | Registered Nurse | 40 Trainor Ave, Center Moriches, NY 11934 | 2009-02-17 |
| 1518096437 | Pamela Anne Mcdonald | Speech-Language Pathologist | 77 Union Street, Out East Occupational Therapy PC, Center Moriches, NY 11934 | 2007-03-05 |
| 1770612194 | Sophia L. Kary | Psychologist | 1 Neville Street, Center Moriches, NY 11934 | 2007-03-02 |
| Find all providers in zip 11934 | ||||
| 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 |
|---|---|---|---|---|
| 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 | CENTER MORICHES |
| Zip Code | 11934 |
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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.