Independent Group Home Living

NPI #1609049337 in Quogue, New York

Provider Information

NPI Number
1609049337
Entity Type
Organization
Organization Name
Independent Group Home Living
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Apr 2, 2008
Last Updated
Apr 7, 2008

Practice Location

Address
7 MONTAUK HIGHWAY
City
Quogue
ZIP Code
11959
Phone
(631) 878-8900

Authorized Official

Name
MR. WALTER W. STOCKTON
Title
CHIEF EXECUTIVE OFFICER
Phone
(631) 878-8900

Specialties & Taxonomy Codes

Specialty
Nursing Facility/Intermediate Care Facility
Intermediate Care Facility, Intellectual Disabilities

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