MEDICARE: YLC ADULT DAYCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1033577283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YLC ADULT DAYCARE INC

Provider Business Mailing Address
First Line	:	9740 64TH AVE
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9740 64TH AVE
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2231
Country	:	US
Telephone Number	:	718-213-9882
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEN LI
Credential	:
Telephone Number	:	718-997-0426

Provider Enumeration Date	:	02/03/2016
Last Update Date	:	03/12/2017

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Directions to “YLC ADULT DAYCARE INC ” Practice Location

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