NPIMap

Organization Active NPI

SG Senior Living, LLC

  • Assisted Living Facility
  • Glen Cove, NY
National Provider Identifier
1780988543
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SG SENIOR LIVING, LLC
Practice address
146 Glen St
Glen Cove, NY 11542-2776
Phone
(516) 671-7008
NPI assigned
Jan 7, 2011
Organization subpart
Yes
Parent organization
SG SENIOR LIVING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Authorized official

Name
John Moore
Title
Ceo
Phone
(502) 779-7608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

146 Glen St
Glen Cove, NY 11542-2776

Mailing address

146 Glen St
Glen Cove, NY 11542-2776
Phone (516) 671-7008

Other names 1

  • Glen Cove Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2192954WG Glen Cove SH LLC146 Glen St, Glen Cove, NY 11542Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
SG Senior Living LLC7 organizations share this tax ID, including this one
Part of
SG Senior Living LLC

Other organizations with this tax ID 6

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": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1780988543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GLEN ST",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422776",
            "telephone_number": "516-671-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 GLEN ST",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422776",
            "telephone_number": "516-671-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG SENIOR LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SG SENIOR LIVING, LLC",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-779-7608"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Cove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.