Healthcare Provider Details

I. General information

NPI: 1255850608
Provider Name (Legal Business Name): C R E ADULT DAY CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9815 HORACE HARDING EXPY STE 1M
CORONA NY
11368-4249
US

IV. Provider business mailing address

9815 HORACE HARDING EXPY STE 1M
CORONA NY
11368-4249
US

V. Phone/Fax

Practice location:
  • Phone: 718-592-1221
  • Fax: 718-592-1229
Mailing address:
  • Phone: 718-592-1221
  • Fax: 718-592-1229

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: MAO WU DONG
Title or Position: PRESIDENT
Credential:
Phone: 718-592-1221