Healthcare Provider Details

I. General information

NPI: 1346779543
Provider Name (Legal Business Name): PARADISE ADULT DAY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WORLDS FAIR DR
SOMERSET NJ
08873-1344
US

IV. Provider business mailing address

23 WORLDS FAIR DR
SOMERSET NJ
08873-1344
US

V. Phone/Fax

Practice location:
  • Phone: 732-595-5315
  • Fax: 732-595-5317
Mailing address:
  • Phone: 732-595-5315
  • Fax: 732-595-5317

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: MR. VLADISLAV TOLCHEV
Title or Position: ADMINISTRATOR
Credential: CALA
Phone: 732-595-5315