Provider Demographics
NPI:1578639845
Name:LIVING RESOURCES CORPORATION
Entity Type:Organization
Organization Name:LIVING RESOURCES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ERLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-346-8888
Mailing Address - Street 1:2176 GUILDERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-4403
Mailing Address - Country:US
Mailing Address - Phone:518-346-8888
Mailing Address - Fax:518-346-7725
Practice Address - Street 1:127 HAYS RD
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1757
Practice Address - Country:US
Practice Address - Phone:518-479-3251
Practice Address - Fax:518-479-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01123826Medicaid