Healthcare Provider Details

I. General information

NPI: 1609178938
Provider Name (Legal Business Name): ADULTCARE INC. SOCIAL DAYCARE PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 MANHATTAN AVE
UNION CITY NJ
07087-5417
US

IV. Provider business mailing address

1607 MANHATTAN AVE
UNION CITY NJ
07087-5417
US

V. Phone/Fax

Practice location:
  • Phone: 201-864-5400
  • Fax: 201-864-1512
Mailing address:
  • Phone: 201-864-5400
  • Fax: 201-864-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHRIS G. ARCHEVALD
Title or Position: ADMINISTRATOR
Credential: CALA
Phone: 201-864-5400