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Contact Information

CONCERN FOR INDEPENDENT LIVING, INC.
312 EXPRESSWAY DRIVE SOUTH
MEDFORD, NY11763
 Phone: 631-750-2225
 Fax: 631-758-0467
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Psychiatric Residential Treatment Facility

323P00000X
Indicates primary specialty

NPI Profile & details for CONCERN FOR INDEPENDENT LIVING, INC.

NPI Number 1427198209
LBN Legal business name CONCERN FOR INDEPENDENT LIVING, INC.
Authorized official RALPH FASANO - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2007
Last updated 05/18/2016 - About 10 years ago
Identifiers
NY License # 7609432
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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