Healthcare Provider Details

I. General information

NPI: 1356835276
Provider Name (Legal Business Name): FLEMINGTON SOCIAL ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WALTER E FORAN BLVD UNIT 309
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

3 WALTER E FORAN BLVD UNIT 309
FLEMINGTON NJ
08822
US

V. Phone/Fax

Practice location:
  • Phone: 732-589-9404
  • Fax:
Mailing address:
  • Phone: 732-589-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAMIR SHAH
Title or Position: CEO
Credential:
Phone: 732-589-9404