| Concern For Independent Living, Inc. | |
|
312 Expressway Drive South Medford NY 11763 | |
| (631) 750-2225 | |
| (631) 758-0467 |
| Full Name | Concern For Independent Living, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 312 Expressway Drive South, Medford, New York |
| Authorized Official Name and Position | Ralph Fasano (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6317580474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concern For Independent Living, Inc. Po Box 358 312 Expressway Drive South Medford NY 11763 Ph: (631) 758-0474 | Concern For Independent Living, Inc. 312 Expressway Drive South Medford NY 11763 Ph: (631) 750-2225 |
| NPI Number | 1427198209 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 05/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427198209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7609432 (New York) | Primary |
| 323P00000X | Psychiatric Residential Treatment Facility | (* (Not Available)) | Secondary |
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