Healthcare Provider Details

I. General information

NPI: 1548165889
Provider Name (Legal Business Name): INGERSOLL ADULT HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3359 CONSAUL RD
SCHENECTADY NY
12304-2207
US

IV. Provider business mailing address

3359 CONSAUL RD
SCHENECTADY NY
12304-2207
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-4419
  • Fax: 518-393-9410
Mailing address:
  • Phone: 518-370-4419
  • Fax: 518-393-9410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAROLINE FOX THOMPSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 518-370-4419