MEDICARE: LA FAMILIA ADULT DAY CENTER 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	:	1871839712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA FAMILIA ADULT DAY CENTER INC.

Provider Business Mailing Address
First Line	:	9425 76TH ST
Second Line	:	PH
City	:	OZONE PARK
State	:	NY
Zip	:	11416-1011
Country	:	US
Telephone Number	:	917-375-2592
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 LIBERTY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-2912
Country	:	US
Telephone Number	:	917-375-2592
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. RAFAELA VILLAFANA
Credential	:	BS
Telephone Number	:	917-375-2592

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	07/22/2016

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