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Living Resources Corporation

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Rensselaer, NY

NPI 1174699441 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1174699441
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
Legal business name
LIVING RESOURCES CORPORATION
Practice address
19 Jefferson Ave
Rensselaer, NY 12144-4611
Phone
(518) 479-3905
Fax
(518) 479-4581
NPI assigned
Nov 28, 2006
Organization subpart
No

Authorized official

Name
Mr. Fredrich William Erlich
Title
Executive Director
Phone
(518) 346-8888

Corporate family (same tax ID) 9

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

National Provider Directory

Tax ID family
Living Resources Corporation (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Yes

Addresses

Primary practice location

19 Jefferson Ave
Rensselaer, NY 12144-4611

Mailing address

2176 Guilderland Ave
Schenectady, NY 12306-4403

Other identifiers

IdentifierTypeStateIssuer
01073638MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174699441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 GUILDERLAND AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123064403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 JEFFERSON AVE",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121444611",
            "telephone_number": "518-479-3905",
            "fax_number": "518-479-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING RESOURCES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERLICH",
        "authorized_official_first_name": "FREDRICH",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "518-346-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "01073638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, NY

All providers in Rensselaer, NY · Intellectual Disabilities Intermediate Care Facility in New York

Sources for this page

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