Healthcare Provider Details

I. General information

NPI: 1053597096
Provider Name (Legal Business Name): MY HOME ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2008
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BROOK AVE
MAYWOOD NJ
07607-1130
US

IV. Provider business mailing address

37 BROOK AVE
MAYWOOD NJ
07607-1130
US

V. Phone/Fax

Practice location:
  • Phone: 201-291-8811
  • Fax: 201-291-8833
Mailing address:
  • Phone: 201-291-8811
  • Fax: 201-291-8833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. PRADIP KABARIA
Title or Position: PRESIDENT
Credential:
Phone: 201-291-8811