Healthcare Provider Details
I. General information
NPI: 1861771321
Provider Name (Legal Business Name): GOLDEN PATH ADULT DAY HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2011
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 CHARLES ST
NEW BRUNSWICK NJ
08901
US
IV. Provider business mailing address
50 CHARLES STREET
NEW BRUNSWICK NJ
08901
US
V. Phone/Fax
- Phone: 732-640-1122
- Fax: 732-640-1118
- Phone: 732-640-1122
- Fax: 732-640-1118
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 | NJ |
VIII. Authorized Official
Name:
VIKTOR
DUBINSKIY
Title or Position: ADMINISTRATOR
Credential:
Phone: 732-640-1122