Provider Demographics
NPI:1124213277
Name:ACCESS: SUPPORTS FOR LIVING INC
Entity Type:Organization
Organization Name:ACCESS: SUPPORTS FOR LIVING INC
Other - Org Name:OCCUPATIONS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON-WINCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-692-4454
Mailing Address - Street 1:15 FORTUNE RD W
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1625
Mailing Address - Country:US
Mailing Address - Phone:845-692-4454
Mailing Address - Fax:845-692-8887
Practice Address - Street 1:15 FORTUNE RD W
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1625
Practice Address - Country:US
Practice Address - Phone:845-692-4454
Practice Address - Fax:845-692-8887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCCUPATIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01189019Medicaid