Healthcare Provider Details

I. General information

NPI: 1477894020
Provider Name (Legal Business Name): GOLDEN CARE ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9716 NORTHERN BLVD 1ST FL
CORONA NY
11368-1044
US

IV. Provider business mailing address

9716 NORTHERN BLVD 1ST FL
CORONA NY
11368-1044
US

V. Phone/Fax

Practice location:
  • Phone: 718-426-4615
  • Fax:
Mailing address:
  • Phone: 718-426-4615
  • 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: MS. BETSEY BARRERA
Title or Position: SOLE MBR
Credential:
Phone: 718-426-4615