Healthcare Provider Details

I. General information

NPI: 1831637404
Provider Name (Legal Business Name): KAPE HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16328 NORTHERN BLVD UNIT 2R
FLUSHING NY
11358-2645
US

IV. Provider business mailing address

16328 NORTHERN BLVD UNIT 2R
FLUSHING NY
11358-2645
US

V. Phone/Fax

Practice location:
  • Phone: 718-869-9906
  • 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: KYONG HOON LEE
Title or Position: PRESIDENT
Credential:
Phone: 718-869-9906