Healthcare Provider Details

I. General information

NPI: 1568846616
Provider Name (Legal Business Name): GOLDEN ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53-57 WEST FORT LEE ROAD
BOGOTA NJ
07603
US

IV. Provider business mailing address

53-57 WEST FORT LEE ROAD
BOGOTA NJ
07603
US

V. Phone/Fax

Practice location:
  • Phone: 201-457-1007
  • Fax: 201-457-1005
Mailing address:
  • Phone: 201-457-1007
  • Fax: 201-457-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: EUNICE PARK
Title or Position: OWNER
Credential:
Phone: 201-457-1007