Healthcare Provider Details

I. General information

NPI: 1992041230
Provider Name (Legal Business Name): BERGEN COUNTY ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 EVELYN ST
PARAMUS NJ
07652-2908
US

IV. Provider business mailing address

340 EVELYN ST
PARAMUS NJ
07652-2908
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-0606
  • Fax: 201-265-0630
Mailing address:
  • Phone: 201-265-0606
  • Fax: 201-265-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberI5W32J
License Number StateNJ

VIII. Authorized Official

Name: MR. SAVAN PATEL
Title or Position: CEO
Credential:
Phone: 201-265-0606