Healthcare Provider Details

I. General information

NPI: 1114744166
Provider Name (Legal Business Name): BLESSED ADULT DAYCARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 UNION ST
FLUSHING NY
11355-2452
US

IV. Provider business mailing address

4123 UNION ST
FLUSHING NY
11355-2452
US

V. Phone/Fax

Practice location:
  • Phone: 646-644-6888
  • Fax:
Mailing address:
  • Phone: 646-644-6888
  • 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: JIFENG JIN
Title or Position: DIRECTOR
Credential:
Phone: 646-644-6888