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General NPI Number Information
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NPI Number | 1568459204
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Entity Type | Organization
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Legal Business Name | THE LONG ISLAND HOME
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 400 SUNRISE HWY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2508
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Country | US
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Telephone | 631-264-4000
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Fax | 631-396-0025
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Provider Business Mailing Address
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Address Line | 400 SUNRISE HWY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2508
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Country | US
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Telephone | 631-264-4000
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Fax | 631-396-0025
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT & CFO
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Name | MS. MICHELE L CUSACK
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Credential |
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Telephone | 516-321-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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