Healthcare Provider Details

I. General information

NPI: 1346637956
Provider Name (Legal Business Name): GOLDEN RETREAT ADULT DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 W RAMAPO AVE
MAHWAH NJ
07430-1619
US

IV. Provider business mailing address

12 WINDING RDG
OAKLAND NJ
07436-2317
US

V. Phone/Fax

Practice location:
  • Phone: 201-927-9434
  • Fax:
Mailing address:
  • Phone: 201-927-9434
  • 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: MRS. PRITI BHARGAVA
Title or Position: PRESIDENT
Credential:
Phone: 201-927-9434