The Lake Grove School

LBN: The Lake Grove School
The Lake Grove School is an health care organization with primary practice located at 3390 Route 112 , Medford NY 11763-1421. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. The Lake Grove School can be contacted via phone (631) 696-1400, or through Wienclaw, Felix via phone (631) 696-1400.

Contact Information

Primary practice address
3390 Route 112 Medford NY 11763-1421
Phone: (631) 696-1400
Fax: (631) 716-2135
Website:
Map and Directions
Authorized official contact:
Name: Wienclaw, Felix
Phone: (631) 696-1400

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X

Profile Details

NPI number 1093981235
LBN Legal business name The Lake Grove School
DBA Doing business as
Authorized official Wienclaw, Felix
Entity Organization
Organization subpart 1 Yes
Enumeration date May 7th, 2008
Last updated May 7th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093981235 NPPES
New York MEDICAID 00892773

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