NPIMap

Organization Active NPI

Independent Group Home Living Program Inc

  • Nursing Facility/Intermediate Care Facility
  • Melville, NY
National Provider Identifier
1164885166
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
INDEPENDENT GROUP HOME LIVING PROGRAM INC
Practice address
908 Melville Estates
Melville, NY 11747
Phone
(631) 878-8900
Fax
(631) 878-8201
NPI assigned
Mar 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Marybeth Licthneger
Title
Cfo
Phone
(631) 878-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

908 Melville Estates
Melville, NY 11747

Mailing address

221 N Sunrise Service Rd
Manorville, NY 11949-9604

National Provider Directory

National Provider Directory
Tax ID family
Independent Group Home Living21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1164885166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N SUNRISE SERVICE RD",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119499604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 MELVILLE ESTATES",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-878-8900",
            "fax_number": "631-878-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT GROUP HOME LIVING PROGRAM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "LICTHNEGER",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-878-8900"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.