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The Lake Grove School
Emotionally Disturbed Childrens' Residential Treatment Facility in Medford, New York
NPI 1093981235

The Lake Grove School is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Medford, NY. The Lake Grove School practices in Medford, NY. The NPI Number for The Lake Grove School is 1093981235 and holds a License No. (New York).

The current practice location address for The Lake Grove School is 3390 Route 112, Medford, NY and can be reached out via phone at 631-696-1400 and via fax at 631-716-2135.

Location: 3390 Route 112, Medford, NY, 11763-0786
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093981235
Provider Name
The Lake Grove School
Credential
Provider Entity Type
Organization
Address
3390 Route 112, Medford, NY, 11763-0786
Phone Number
631-696-1400
Fax Number
631-716-2135
Provider Enumeration Date
05/07/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00892773 05 NY
institution
Provider Business Practice Location Address Details
Address
3390 Route 112
City
Medford
State
New York
Zip
11763-1421
Phone Number
631-696-1400
Fax Number
631-716-2135
person
Provider Business Mailing Address Details
Address
3390 Route 112
City
Medford
State
New York
Zip
11763-1421
Phone Number
631-696-1400
Fax Number
631-716-2135
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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