MEDICARE: SENIOR CENTER ADULT DAY CARE CORP.

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	:	1154603165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR CENTER ADULT DAY CARE CORP.

Provider Business Mailing Address
First Line	:	3925 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6706
Country	:	US
Telephone Number	:	305-982-8217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6706
Country	:	US
Telephone Number	:	305-982-8217
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARTA RANGEL
Credential	:
Telephone Number	:	305-982-8217

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	10/10/2011

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