Healthcare Provider Details

I. General information

NPI: 1306918685
Provider Name (Legal Business Name): ELMHURST CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10017 23RD AVENUE
EAST ELMHURST NY
11369
US

IV. Provider business mailing address

10017 23RD AVENUE
EAST ELMHURST NY
11369
US

V. Phone/Fax

Practice location:
  • Phone: 718-205-8100
  • Fax: 718-507-7503
Mailing address:
  • Phone: 718-205-8100
  • Fax: 718-507-7503

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 Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YOSSI KRAUS
Title or Position: AST ADMINISTRATOR
Credential:
Phone: 718-247-6141