OrganizationActive
Independent Group Home Living Program Inc
NPI 1164885166 · Nursing Facility/Intermediate Care Facility · Melville, NY
Provider details
- NPI number
- 1164885166
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Marybeth Licthneger, Cfo(631) 878-8900
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
908 Melville Estates
Melville, NY 11747
Phone: (631) 878-8900
Fax: (631) 878-8201
Approximate (ZIP-level) locationGet directions
Mailing address
221 N Sunrise Service Rd
Manorville, NY 11949-9604
Registry dates
- Enumerated
- 2016-03-29
- Last updated
- 2016-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.