Healthcare Provider Details
I. General information
NPI: 1982878567
Provider Name (Legal Business Name): MORNING STAR ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 KYLE WAY
EWING NJ
08628-2523
US
IV. Provider business mailing address
90 KYLE WAY
EWING NJ
08628-2523
US
V. Phone/Fax
- Phone: 609-718-0153
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
LARBI
Title or Position: DIRECTOR
Credential:
Phone: 917-385-4772