Healthcare Provider Details

I. General information

NPI: 1154795094
Provider Name (Legal Business Name): BLUE SKY ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 CHERRY AVE
FLUSHING NY
11355-4711
US

IV. Provider business mailing address

13440 CHERRY AVE
FLUSHING NY
11355-4711
US

V. Phone/Fax

Practice location:
  • Phone: 718-483-0049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. XIAO HE
Title or Position: DIRECTOR
Credential: DIRECTOR
Phone: 212-495-9798