CRYSTAL RUN VILLAGE, INC (NPI# 1083831036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083831036 |
| Entity Type | Organization |
| Organization Name | CRYSTAL RUN VILLAGE, INC |
| Practice Address |
601 Stony Ford Rd Middletown NY 10941 |
| Practice Telephone | 8456924444 |
| Practice Fax Number | 8456921101 |
| Mailing Telephone | 8456924444 |
| Mailing Fax Number | 8456921101 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WILLIAM SAMMIS (DEPUTY ED OF ADMIN SERVICES) |
| Authorized Official Telephone | 8456952559 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386778546 | Crystal Run Village, Inc | Intermediate Care Facility, Mentally Retarded | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2007-03-16 |
| Street Address |
601 STONY FORD RD |
| City | MIDDLETOWN |
| State | NY |
| Zip Code | 10941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386778546 | Crystal Run Village, Inc | Intermediate Care Facility, Mentally Retarded | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2007-03-16 |
| 1134407760 | Crystal Run Village, Inc. | Case Management | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2011-08-01 |
| 1619123999 | Crystal Run Village | Assisted Living Facility | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2008-08-18 |
| 1619149077 | Crystal Run Village Inc | Intermediate Care Facility, Mentally Retarded | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2008-03-26 |
| 1619149069 | Crystal Run Village Inc | Intermediate Care Facility, Mentally Retarded | 601 Stony Ford Rd, Middletown, NY 10941-3951 | 2008-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471428 | Jackeline Montoya | Case Manager/Care Coordinator | 13 Kensington Manor, Middletown, NY 10941 | 2020-06-15 |
| 1124502398 | Kimberly Dominique Mccormick | Licensed Practical Nurse | 29, Macintosh Drive, Middletown, NY 10941 | 2018-09-24 |
| 1750891081 | Heather Skinner | Case Manager/Care Coordinator | 75 Crystal Run Rd Suite 201, Middletown, NY 10941 | 2017-09-29 |
| 1295281012 | Christa Lloyd | Counselor | 15 Fortune Rd, West Middletown, NY 10941 | 2016-08-31 |
| 1023471109 | Lauren Battaglia | Occupational Therapy Assistant | 192 Tower Drive Suite 400, Middletown, NY 10941 | 2016-04-05 |
| 1992188718 | Brynn Sierra | Occupational Therapist | 21 Riverside Drive, Middletown, NY 10941 | 2015-06-30 |
| 1356788574 | Keren Denis Joseph | Custodial Care Facility | 16 Disco Dr, Middletown, NY 10941 | 2013-05-29 |
| 1902169204 | Susan A. Reilly | Specialist | 2277 Gosen Turnpike, Middletown, NY 10941 | 2012-06-21 |
| 1518229392 | Dena Sapp | Case Manager/Care Coordinator | 75 Crystal Run Rd. Suite 201, Middletown, NY 10941 | 2012-06-08 |
| 1770800542 | Orange County Medical Transportation Inc. | Taxi | 80 Wisner Avenue, Middletown, NY 10941 | 2010-05-03 |
| Find all providers in zip 10941 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
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| 1730512344 | Abilities In Action | Day Training, Developmentally Disabled Services | 63 Deepdale Dr, Middletown, NJ 07748-3006 | 2013-08-19 |
| 1164543765 | Looking Upwards, Inc. | Day Training, Developmentally Disabled Services | 438 E Main Rd, Middletown, RI 02842-7263 | 2007-04-02 |
| 1578693172 | Looking Upwards, Inc. | Day Training, Developmentally Disabled Services | 438 E Main Rd, Middletown, RI 02842-7263 | 2007-03-06 |
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| 1679120638 | Justin Rigas | Day Training, Developmentally Disabled Services | 523 Montauk Hwy, East Moriches, NY 11940-1372 | 2019-08-23 |
| 1639722358 | Jewel Human Services, Inc | Day Training, Developmentally Disabled Services | 15231 134th Ave, Jamaica, NY 11434-3528 | 2019-07-22 |
| 1164996534 | Ranj Family of Services | Day Training, Developmentally Disabled Services | 25 Roman Acres Dr, Garnerville, NY 10923-1111 | 2019-01-18 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLETOWN |
| Zip Code | 10941 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.