Provider Demographics
NPI:1053834143
Name:ACCESS CENTER FOR INDEPEDENT LIVING
Entity Type:Organization
Organization Name:ACCESS CENTER FOR INDEPEDENT LIVING
Other - Org Name:ACCESS CENTER FOR INDEPENDENT LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-476-3600
Mailing Address - Street 1:3100 VETERANS MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-1052
Mailing Address - Country:US
Mailing Address - Phone:631-476-3600
Mailing Address - Fax:
Practice Address - Street 1:3100 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-1052
Practice Address - Country:US
Practice Address - Phone:631-476-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS HOME CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care