Healthcare Provider Details

I. General information

NPI: 1699287045
Provider Name (Legal Business Name): SBNH ACQUISITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 QUARRY RD
BRONX NY
10457-1663
US

IV. Provider business mailing address

2175 QUARRY RD
BRONX NY
10457-1663
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-3910
  • Fax:
Mailing address:
  • Phone:
  • 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: ANDREW BLATT
Title or Position: CONSULTANT
Credential:
Phone: 914-630-4543