Healthcare Provider Details

I. General information

NPI: 1477996080
Provider Name (Legal Business Name): OKADULTDAYCARECENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018 8TH AVE
BROOKLYN NY
11232-3759
US

IV. Provider business mailing address

4018 8TH AVE
BROOKLYN NY
11232-3759
US

V. Phone/Fax

Practice location:
  • Phone: 917-500-8421
  • Fax: 347-227-7994
Mailing address:
  • Phone: 917-500-8421
  • Fax: 347-227-7994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. JIANSHENG LIN
Title or Position: PRESIDENT
Credential:
Phone: 917-500-8421