Healthcare Provider Details

I. General information

NPI: 1639822158
Provider Name (Legal Business Name): GOOD MORNING ADULT DAYCARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13610 BOOTH MEMORIAL AVE
FLUSHING NY
11355-5010
US

IV. Provider business mailing address

13610 BOOTH MEMORIAL AVE
FLUSHING NY
11355-5010
US

V. Phone/Fax

Practice location:
  • Phone: 929-362-2102
  • Fax: 929-362-2600
Mailing address:
  • Phone: 718-877-6917
  • Fax: 929-362-2600

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: BRYAN CHAN
Title or Position: PRESIDENT
Credential:
Phone: 929-362-2102