Healthcare Provider Details

I. General information

NPI: 1003248386
Provider Name (Legal Business Name): SUNSHINE ADULT SOCIAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 03/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 LAFAYETTE AVE
BRONX NY
10474-5336
US

IV. Provider business mailing address

130 OCEANA DR W UNIT PH2
BROOKLYN NY
11235-6998
US

V. Phone/Fax

Practice location:
  • Phone: 917-567-0235
  • Fax:
Mailing address:
  • Phone: 917-567-0235
  • Fax:

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. ARKADY KHAVULYA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 646-642-0395