PARK INN HOME
NPI 1760190599
Custodial Care Facility - Adult Care Home in Rockaway Park, NY

Active since November 10, 2022CLIA 33D2236733 · Waiver
11502 OCEAN PROMENADE, ROCKAWAY PARK, NY 11694(718) 634-3400 Get Directions Write a Review

NPPES record last updated: November 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Park Inn Home NPPES

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

PARK INN HOME (NPI 1760190599) is a healthcare organization registered as an adult care home in Rockaway Park, New York and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jennifer Grajales, Director Of Special Projects, as its authorized official.

NPPES Registry Identity

NPI1760190599
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NamePARK INN HOME
Location Address11502 OCEAN PROMENADERockaway Park, NY 11694-2412
Mailing Address2357 60th StBrooklyn, NY 11204-2689
Organization SubpartNo
Authorized OfficialJennifer GrajalesDirector Of Special Projects · (347) 988-4535
Enumeration DateNovember 10, 2022
NPPES CertifiedNovember 10, 2022
NPI 1760190599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
11502 OCEAN PROMENADE, Rockaway Park, NY 11694

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2236733

Park Inn Home · Rockaway Park, NY
Active · expires Mar 26, 2027
CLIA Number33D2236733
Laboratory TypeAdult Home
Certificate Effective DateSeptember 20, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Peyman E. Younesi
Laboratory Phone(718) 634-3400
Laboratory LocationPark Inn Home115-02 Ocean Promenade, Rockaway Park, NY 11694
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

Custodial Care Facility
11502 OCEAN PROMENADE
ROCKAWAY PARK, NY 11694
Clinic/Center (Adult Day Care)
11502 OCEAN PROMENADE
ROCKAWAY PARK, NY 11694
Speech-Language Pathologist
11502 OCEAN PROMENADE
ROCKAWAY PARK, NY 11694
Physical Therapist
11502 OCEAN PROMENADE
ROCKAWAY PARK, NY 11694
Speech-Language Pathologist
11502 OCEAN PROMENADE
BELLE HARBOR, NY 11694
Social Worker (Clinical)
11502 OCEAN PROMENADE
ROCKAWAY PARK, NY 11694

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 Park Inn Home's NPI number?

The NPI number for Park Inn Home is 1760190599. It was assigned to this organization in the NPPES registry on November 10, 2022.

Where is Park Inn Home located?

Park Inn Home is located at 11502 Ocean Promenade, Rockaway Park, NY 11694. The listed phone number is (718) 634-3400.

What is Park Inn Home's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Park Inn Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2236733) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Park Inn Home was last updated on November 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.