Healthcare Provider Details

I. General information

NPI: 1346978624
Provider Name (Legal Business Name): WISHFUL ADULT DAY CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14230 38TH AVE
FLUSHING NY
11354-5526
US

IV. Provider business mailing address

14230 38TH AVE
FLUSHING NY
11354-5526
US

V. Phone/Fax

Practice location:
  • Phone: 917-909-9786
  • 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 State

VIII. Authorized Official

Name: HAIYAN YANG
Title or Position: PRESIDENT
Credential:
Phone: 917-909-9786