OrganizationActive
Independent Group Home Living
NPI 1891865721 · Nursing Facility/Intermediate Care Facility · Manorville, NY
Provider details
- NPI number
- 1891865721
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Walter Stockton, Chief Executive Officer(631) 878-8900
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
221 N. Sunrise Service Rd.
Manorville, NY 11949
Phone: (631) 878-8900
Fax: (631) 878-8201
Approximate (ZIP-level) locationGet directions
Mailing address
221 N. Sunrise Service Rd.
Manorville, NY 11949
Registry dates
- Enumerated
- 2006-11-08
- Last updated
- 2008-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.