Healthcare Provider Details

I. General information

NPI: 1467222422
Provider Name (Legal Business Name): ONE ADULT DAYCARE CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MEHRHOF RD
LITTLE FERRY NJ
07643-2125
US

IV. Provider business mailing address

136 MEHRHOF RD
LITTLE FERRY NJ
07643-2125
US

V. Phone/Fax

Practice location:
  • Phone: 201-572-2422
  • Fax:
Mailing address:
  • Phone:
  • 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: HANNA KIM
Title or Position: ADMINISTRATOR
Credential:
Phone: 201-572-2422