Healthcare Provider Details

I. General information

NPI: 1013871789
Provider Name (Legal Business Name): BROADWAY ADULT DAY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 COLDEN ST STE 101
FLUSHING NY
11355-3981
US

IV. Provider business mailing address

4231 COLDEN ST STE 101
FLUSHING NY
11355-3981
US

V. Phone/Fax

Practice location:
  • Phone: 347-368-4472
  • Fax:
Mailing address:
  • Phone: 347-368-4472
  • 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: LIANG CHENG GUO
Title or Position: PRESIDENT
Credential:
Phone: 212-203-3723