Community Living Corporation

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

COMMUNITY LIVING CORPORATION

Practice address

105 South Bedford Road
Mount Kisco, NY 10549

Phone

(914) 241-3628

Fax

(914) 241-1109

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

John E Porcella, PHD

Title

Executive Director

Phone

(914) 241-3628

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275678500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTH BEDFORD ROAD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-241-3628",
            "fax_number": "914-241-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTH BEDFORD ROAD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-241-3628",
            "fax_number": "914-241-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PORCELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "914-241-3628",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02247230",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02247258",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01387842",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01997286",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02557931",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02171819",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02557940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Cohn, D.M.D.
• Deirdre A. Cole, LCSW, BCD
• Margaret A Collins, MD
• Marina Colon
• Community Hearing Services
• Kristin Conklin, DPT
• Camara Consingh
• Michelle Conway, CASAC-T
• William J Cook, LCSW R
• Victoria Coon, FAP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Mount Kisco, NY
• Providers in Mount Kisco, NY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment 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.