PLAZA AT CLOVER LAKE
NPI 1558810259
Assisted Living Facility in Carmel, NY

Q: What is Clover Lake Management LLC's NPI number?

The NPI number for Clover Lake Management LLC is 1558810259. It was assigned to this organization in the NPPES registry on September 23, 2016. The provider is doing business as Plaza At Clover Lake.

Q: What is Clover Lake Management LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since September 23, 2016

838 FAIR ST, CARMEL, NY 10512(845) 878-4111 Get Directions Write a Review

NPPES record last updated: September 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Plaza At Clover Lake NPPES

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

PLAZA AT CLOVER LAKE (NPI 1558810259) is a healthcare organization registered as an assisted living facility in Carmel, New York and active in the NPI registry since September 2016. The organization lists Charles Edouard Gros, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1558810259

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameCLOVER LAKE MANAGEMENT LLC

Location Address838 FAIR STCarmel, NY 10512-3085

Mailing Address838 Fair StCarmel, NY 10512-3085 · (845) 878-4111

Phone(845) 878-4111

Organization SubpartNo

Authorized OfficialCharles Edouard GrosManaging Member · (718) 360-8083

Enumeration DateSeptember 23, 2016

✔ NPI 1558810259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in NY · 580F001

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

838 FAIR ST, Carmel, NY 10512

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Other Names 1

Doing Business AsPlaza At Clover Lake

Other Identifiers 1

Medicaid03547748NY

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.

TRINITY PHYSICAL THERAPY PC

Exclusive Provider Organization

838 FAIR ST
CARMEL, NY 10512

Putnam County (845) 279-5111

BERNARD ANTWI FNP

Nurse Practitioner (Family)

838 FAIR ST
CARMEL, NY 10512

Putnam County (917) 722-8839

CHRISTABEL AKPENUCHI DIKE

Internal Medicine

838 FAIR ST
CARMEL, NY 10512

Putnam County (770) 310-7292

DR. KENNEDY AMACHI MD

Internal Medicine (Geriatric Medicine)

838 FAIR ST
CARMEL, NY 10512

Putnam County (914) 236-4121

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 Clover Lake Management LLC's NPI number?

The NPI number for Clover Lake Management LLC is 1558810259. It was assigned to this organization in the NPPES registry on September 23, 2016. The provider is doing business as Plaza At Clover Lake.

Where is Clover Lake Management LLC located?

Clover Lake Management LLC is located at 838 Fair St, Carmel, NY 10512. The listed phone number is (845) 878-4111.

What is Clover Lake Management LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Clover Lake Management LLC was last updated on September 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.