Independent Group Home Living

LBN: Independent Group Home Living
Independent Group Home Living is an health care organization with primary practice located at 200 A Gibbs Pond Rd , Nesconset NY 11767. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty. Independent Group Home Living can be contacted via phone (631) 878-8900, or through Stockton, Walter W. via phone (631) 878-8900.

Contact Information

Primary practice address
200 A Gibbs Pond Rd Nesconset NY 11767
Phone: (631) 878-8900
Fax: (631) 878-8201
Website:
Map and Directions
Authorized official contact:
Name: Stockton, Walter W.
Phone: (631) 878-8900

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1992978456
LBN Legal business name Independent Group Home Living
DBA Doing business as
Authorized official Stockton, Walter W.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 7th, 2008
Last updated Apr 7th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992978456 NPPES
New York MEDICAID 00575168

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