Healthcare Provider Details

I. General information

NPI: 1912474727
Provider Name (Legal Business Name): IYAHO ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 WESTCHESTER AVENUE
BRONX NY
10462
US

IV. Provider business mailing address

2026 WESTCHESTER AVENUE
BRONX NY
10462
US

V. Phone/Fax

Practice location:
  • Phone: 347-727-4585
  • Fax:
Mailing address:
  • Phone: 347-727-4585
  • 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: EHIAVEKHAN EROMOSELE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 347-727-4585