Healthcare Provider Details

I. General information

NPI: 1144476565
Provider Name (Legal Business Name): ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 BEACH CHANNEL DR
FAR ROCKAWAY NY
11691-1110
US

IV. Provider business mailing address

5015 BEACH CHANNEL DR
FAR ROCKAWAY NY
11691-1110
US

V. Phone/Fax

Practice location:
  • Phone: 718-734-2548
  • Fax: 718-734-2545
Mailing address:
  • Phone: 718-734-2548
  • Fax: 718-734-2545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number7003308N
License Number StateNY

VIII. Authorized Official

Name: JANET MIELE-POWERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-734-2750