Provider Demographics
NPI:1891016192
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:845-692-8682
Practice Address - Street 1:87 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5113
Practice Address - Country:US
Practice Address - Phone:845-692-4454
Practice Address - Fax:845-692-8682
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCCUPATIONS, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-21
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00A10211322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03234544Medicaid