Healthcare Provider Details

I. General information

NPI: 1427647569
Provider Name (Legal Business Name): 2ND HOME ADC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 BOSTON RD
BRONX NY
10467-9004
US

IV. Provider business mailing address

25 E SALEM ST STE 500
HACKENSACK NJ
07601-7400
US

V. Phone/Fax

Practice location:
  • Phone: 516-672-2621
  • Fax:
Mailing address:
  • Phone: 516-672-2621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STEPHEN FRUCHTER
Title or Position: OWNER
Credential:
Phone: 516-672-2621