The W Group at Jeffersonville, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

THE W GROUP AT JEFFERSONVILLE, LLC

Doing business as

Jeff Senior Living
Jeffersonville Senior Living

Practice address

4806 Route 52
Jeffersonville, NY 12748

Phone

(845) 482-4375

NPI assigned

Oct 13, 2021

Last updated

Oct 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Grajales

Title

Project Manager

Phone

(347) 988-4535

Specialties & licenses 1

Addresses

Other names 2

• Jeff Senior Living Doing business as
• Jeffersonville Senior Living Doing business as

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1669134920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 60TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4806 ROUTE 52",
            "city": "JEFFERSONVILLE",
            "state": "NY",
            "postal_code": "12748",
            "telephone_number": "845-482-4375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4804 Route 52",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "NY",
            "postal_code": "12748",
            "country_code": "US",
            "telephone_number": "845-274-2744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE W GROUP AT JEFFERSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "GRAJALES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "347-988-4535"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeff Senior Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jeffersonville Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Allen Sager, D.C.
• Maegan Rae Sauer, O.D.
• Susan Elizabeth Schadt, RN
• Patricia Ann Scott, LPN
• Sullivan West Central School District
• Jerome Edward Triolo, D.D.S.
• Janet Wagner
• Ilona Winburn

• Adult Care Home Facility in Jeffersonville, NY
• Providers in Jeffersonville, NY by specialty
• Adult Care Home Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.