National Provider Identifier Database

ELDERBERRY ICF
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.


Contact Information

ELDERBERRY ICF
15 POEM PLACE
MONTICELLO, NY12701
Phone: 845-707-8341
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for ELDERBERRY ICF

NPI Number 1427696061
Legal business name
LBN
ELDERBERRY ICF
Authorized official PHILIP MORACI - (VP BUSINESS DEVELOPMENT)
Entity Organization
Organization subpart Yes
Enumeration date 12/13/2019
Last updated 12/13/2019 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • NY Other: 74670475 OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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