Little Village House, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

LITTLE VILLAGE HOUSE, INC.

Practice address

150 Port Washington Blvd
Manhasset, NY 11030-1714

Phone

(516) 365-4480

Fax

(516) 365-4438

NPI assigned

Feb 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Caryl Bank

Title

Director

Phone

(516) 520-6003

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083754303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HICKSVILLE RD",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831328",
            "telephone_number": "516-520-6000",
            "fax_number": "516-520-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PORT WASHINGTON BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301714",
            "telephone_number": "516-365-4480",
            "fax_number": "516-365-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE VILLAGE HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANK",
        "authorized_official_first_name": "CARYL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-520-6003",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01102809",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Intellectual Disabilities Intermediate Care Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.