FAGAN RESIDENCE
NPI 1730209362
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Elmont, NY

Active since March 29, 2007
1504 DEPAUL ST, ELMONT, NY 11003(631) 665-3434 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fagan Residence NPPES

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

FAGAN RESIDENCE (NPI 1730209362) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Elmont, New York and active in the NPI registry since March 2007. The organization lists Edwin M Kennedy, Cfo, as its authorized official.

NPPES Registry Identity

NPI1730209362
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameFAGAN RESIDENCE
Location Address1504 DEPAUL STElmont, NY 11003-1900
Mailing Address1504 Depaul StElmont, NY 11003-1900 · (631) 665-3434
Organization SubpartNo
Authorized OfficialEdwin M KennedyCfo · (516) 733-7000
Enumeration DateMarch 29, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1730209362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
License Licensed in NY · 6186445
Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

1504 DEPAUL ST, Elmont, NY 11003

Other Identifiers 1

Medicaid02245930NY

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 Fagan Residence's NPI number?

The NPI number for Fagan Residence is 1730209362. It was assigned to this organization in the NPPES registry on March 29, 2007.

Where is Fagan Residence located?

Fagan Residence is located at 1504 Depaul St, Elmont, NY 11003. The listed phone number is (631) 665-3434.

What is Fagan Residence's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Fagan Residence was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.