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Contact Information

INDEPENDENT GROUP HOME LIVING
288 CHAPMAN BLVD
MANORVILLE, NY11949-3125
 Phone: 631-878-8900
 Fax: 631-878-8201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intermediate Care Facility, Mentally Retarded

315P00000X
Indicates primary specialty

NPI Profile & details for INDEPENDENT GROUP HOME LIVING

NPI Number 1629241195
LBN Legal business name INDEPENDENT GROUP HOME LIVING
Authorized official WALTER STOCKTON - (C.E.O.)
Entity Organization
Organization subpart 1 No
Enumeration date 04/07/2008
Last updated 04/07/2008 - About 18 years ago
Identifiers
NY Medicaid 00883876
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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