Independent Group Home Living
NPI #1801069364 in East Quogue, New York
Provider Information
- NPI Number
- 1801069364
- Entity Type
- Organization
- Organization Name
- Independent Group Home Living
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Apr 7, 2008
- Last Updated
- Apr 7, 2008
Practice Location
- Address
- 135 OLD COUNTRY RD
- City
- East Quogue
- State
- New York
- ZIP Code
- 11942
- Phone
- (631) 878-8900
Authorized Official
- Name
- MR. WALTER W STOCKTON
- Title
- C.E.O.
- Phone
- (631) 878-8900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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