Provider Demographics
NPI:1528174976
Name:ACCESS: SUPPORTS FOR LIVING INC
Entity type:Organization
Organization Name:ACCESS: SUPPORTS FOR LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON-WINCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-692-4454
Mailing Address - Street 1:15 FORTUNE ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941
Mailing Address - Country:US
Mailing Address - Phone:845-692-4454
Mailing Address - Fax:845-692-8887
Practice Address - Street 1:15 FORTUNE ROAD WEST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941
Practice Address - Country:US
Practice Address - Phone:845-692-4454
Practice Address - Fax:845-692-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00911188Medicaid
4576169OtherAETNA INSURANCE
110132500OtherACS
NY01324730Medicaid
7025098OtherAETNA INSURANCE
7686768OtherAETNA INSURANCE
965762AOtherMVP INSURANCE
NY01189019Medicaid
NY02170203Medicaid
319122299OtherGHI VALUE OPTIONS
1018450OtherBEACON HEALTH INS COMPANY
NY00275085Medicaid
7209729OtherAETNA INSURANCE
7360125OtherAETNA INSURANCE
965762OtherMVP INSURANCE
W01502Medicare UPIN
7686768OtherAETNA INSURANCE
7025098OtherAETNA INSURANCE
NY00911188Medicaid
W01501Medicare UPIN