Healthcare Provider Details

I. General information

NPI: 1407435142
Provider Name (Legal Business Name): AMERICAN ADULT DAY CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/07/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 EAST 138TH STREET GROUND FLOOR
BRONX NY
10454
US

IV. Provider business mailing address

132-41 41 ROAD GROUND FLOOR
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 646-708-3808
  • Fax: 718-445-6688
Mailing address:
  • Phone: 646-708-3808
  • Fax: 718-445-6688

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: MISS ANNA LO
Title or Position: DIRECTOR
Credential:
Phone: 646-708-3808