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Independent Group Home Living

Independent Group Home Living is a health care provider in Manorville, NY. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 125 Sebonic Rd, South Hampton, NY 11955, US
Practice Location Phone631-878-8900
Practice Location Fax631-878-8201
Legal Business NameINDEPENDENT GROUP HOME LIVING
NPI ?1275706731
Entity TypeOrganization
Enumeration Date ? Apr 7, 2008
Last Update Date ? Apr 7, 2008
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Independent Group Home Living

SpecialtySpecializationLicenseLicense State
Intermediate Care Facility, Mentally Retarded

legacy-id-icon Legacy Provider IDs of Independent Group Home Living

Provider IdIssuer StateIssuer TypeIssuer
01060526New YorkMedicaid

official-icon Authorized Official of Independent Group Home Living

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Independent Group Home Living's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Walter W Stockton
Authorized Official Title/PositionC.E.O.
Authorized Official Phone Number631-878-8900