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Independent Group Home Living

NPI #1992978456 in Nesconset, New York

Provider Information

NPI Number
1992978456
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
200 A GIBBS POND RD
City
Nesconset
State
New York
ZIP Code
11767
Phone
(631) 878-8900

Authorized Official

Name
MR. WALTER W. STOCKTON
Title
C.E.O.
Phone
(631) 878-8900

Specialties & Taxonomy Codes

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

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