1. Home
  2. Directory
  3. New York
  4. Medford
  5. Residential Treatment Facility Emotionally Disturbed Children
  6. NPI Profile

THE LAKE GROVE SCHOOL
NPI 1093981235
Residential Treatment Facility, Emotionally Disturbed Children in Medford, NY

Active since May 07, 2008
3390 ROUTE 112, MEDFORD, NY 11763(631) 696-1400(631) 716-2135 Get Directions Write a Review

NPPES record last updated: May 7, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About The Lake Grove School NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE LAKE GROVE SCHOOL (NPI 1093981235) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Medford, New York and active in the NPI registry since May 2008. The organization lists Felix Wienclaw, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1093981235
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameTHE LAKE GROVE SCHOOL
Location Address3390 ROUTE 112Medford, NY 11763-1421
Mailing AddressPo Box 786Medford, NY 11763-0786 · (631) 969-1400 · Fax (631) 716-2135
Phone(631) 696-1400
Fax(631) 716-2135
Organization SubpartYesParent: Windwood Meadow, Inc.
Authorized OfficialFelix WienclawChief Financial Officer · (631) 696-1400
Enumeration DateMay 7, 2008
✔ NPI 1093981235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
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.
3390 ROUTE 112, Medford, NY 11763
Open in Google Maps ↗

Other Identifiers 1

Medicaid00892773NY

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NAIMA S GRAY LMSW
Social Worker
3390 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 669-5355
MS. SAMANTHA RAE DESANTIS LMSW
Social Worker
3390 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 512-4092
MS. ERLANDE D CADET RN
Registered Nurse
3390 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 252-8176
PATRICIA ELENA TORRES LPN
Licensed Practical Nurse
3390 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 512-4092

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Lake Grove School's NPI number?

The NPI number for The Lake Grove School is 1093981235. It was assigned to this organization in the NPPES registry on May 7, 2008.

Where is The Lake Grove School located?

The Lake Grove School is located at 3390 Route 112, Medford, NY 11763. The listed phone number is (631) 696-1400.

What is The Lake Grove School's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for The Lake Grove School was last updated on May 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.