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General NPI Number Information
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NPI Number | 1932107927
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Entity Type | Organization
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Legal Business Name | ACTIVE RETIREMENT COMMUNITY, INC.
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 500 MATHER DR
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720-4701
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Country | US
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Telephone | 631-650-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1 JEFFERSON FERRY DR.
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City | S. SETAUKET
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State | NY
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Zip | 11720
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Country | US
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Telephone | 631-650-2600
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Fax | 631-650-2620
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | ROBERT CAULFIELD
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Credential |
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Telephone | 631-650-2610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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