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ICL INDIVIDUAL SUPPORT SERVICES NPI 1205166113


NPI Information

NPI: 1205166113
Provider Name: ICL INDIVIDUAL SUPPORT SERVICES
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
40 RECTOR ST FL 11
NEW YORK, NY
ZIP 10006
Phone: (212) 385-3030
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ICL INDIVIDUAL SUPPORT SERVICES is a day training developmentally disabled services in New York, NY. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. ICL INDIVIDUAL SUPPORT SERVICES NPI is 1205166113. The provider is registered as an organization entity type.

The provider's business location address is:

40 RECTOR ST FL 11
NEW YORK, NY
ZIP 10006-705
Phone: (212) 385-3030

The provider's authorized official is Dewey Howard .
The authorized official title is Cfo and has the following contact phone number (212) 385-3030.

The enumeration date for this NPI number is 12/29/2009 and was last updated on 12/29/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10141009MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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