Healthcare Provider Details

I. General information

NPI: 1932443306
Provider Name (Legal Business Name): TREMONT ADULT DAYCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2012
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E TREMONT AVE
BRONX NY
10460-4301
US

IV. Provider business mailing address

901 E TREMONT AVE
BRONX NY
10460-4301
US

V. Phone/Fax

Practice location:
  • Phone: 347-537-5222
  • Fax: 718-764-4338
Mailing address:
  • Phone: 347-537-5222
  • Fax: 718-764-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: RUTH JACOBOVITCH
Title or Position: DIRECTOR
Credential:
Phone: 347-926-4134