NPIMap

Organization Active NPI

Crystal Run Village Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Middletown, NY
National Provider Identifier
1619149077
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
CRYSTAL RUN VILLAGE INC
Practice address
601 Stony Ford Rd
Middletown, NY 10941-3951
Phone
(845) 692-4444
Fax
(845) 695-1101
NPI assigned
Mar 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Mr. William Sammis
Title
Deputy Director of Admin Services
Phone
(845) 695-2559

Specialties & licenses 1

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

Addresses

Primary practice location

601 Stony Ford Rd
Middletown, NY 10941-3951

Mailing address

601 Stony Ford Rd
Middletown, NY 10941-3951
Phone (845) 692-4444

National Provider Directory

National Provider Directory
Tax ID family
Crystal Run Village Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1619149077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 STONY FORD RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109413951",
            "telephone_number": "845-692-4444",
            "fax_number": "845-695-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 STONY FORD RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109413951",
            "telephone_number": "845-692-4444",
            "fax_number": "845-695-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RUN VILLAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "SAMMIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR OF ADMIN SERVICES",
        "authorized_official_telephone_number": "845-695-2559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.