Healthcare Provider Details

I. General information

NPI: 1689051732
Provider Name (Legal Business Name): PRINCETON ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 ROUTE 130
SOUTH BRUNSWICK NJ
08810
US

IV. Provider business mailing address

2245 ROUTE 130
SOUTH BRUNSWICK NJ
08810
US

V. Phone/Fax

Practice location:
  • Phone: 609-577-0588
  • Fax: 732-584-2432
Mailing address:
  • Phone: 609-577-0588
  • Fax: 732-584-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAHRUKH JOVINDAH
Title or Position: OWNER
Credential:
Phone: 609-577-0588