Healthcare Provider Details

I. General information

NPI: 1518746171
Provider Name (Legal Business Name): PEACEFUL HOME SOCIAL DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13621 LATIMER PL STE CF1A
FLUSHING NY
11354-2994
US

IV. Provider business mailing address

13621 LATIMER PL STE CF1A
FLUSHING NY
11354-2994
US

V. Phone/Fax

Practice location:
  • Phone: 718-886-8988
  • Fax:
Mailing address:
  • Phone: 718-886-8988
  • 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: MR. PING CAO
Title or Position: MANAGER
Credential:
Phone: 718-886-8988