Healthcare Provider Details

I. General information

NPI: 1417406869
Provider Name (Legal Business Name): KANG HUA ADULT DAYCARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 MAIN ST STE 2G
FLUSHING NY
11355-3958
US

IV. Provider business mailing address

4235 MAIN ST STE 2G
FLUSHING NY
11355-3958
US

V. Phone/Fax

Practice location:
  • Phone: 917-930-9688
  • 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
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: KA-YEE KO
Title or Position: PRESIDENT
Credential:
Phone: 917-930-9688