NPI 1164885166
Independent Group Home Living Program INC
Practice location
- Address
- 908 Melville Estates, Melville, NY 11747
- Phone
- (631) 878-8900
- Fax
- (631) 878-8201
- Mailing address
- 221 N Sunrise Service Rd, Manorville, NY 11949-9604
Authorised official
- Name
- Marybeth Licthneger
- Title
- Cfo
- Phone
- (631) 878-8900
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1164885166
- Entity type
- Organization
- NPI issued
- 29 Mar 2016
- Record last updated
- 29 Mar 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.