Healthcare Provider Details

I. General information

NPI: 1023473188
Provider Name (Legal Business Name): PREMIER SOCIAL ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 FULTON AVE
HEMPSTEAD NY
11550-3706
US

IV. Provider business mailing address

115 FULTON AVE
HEMPSTEAD NY
11550-3706
US

V. Phone/Fax

Practice location:
  • Phone: 516-280-8111
  • Fax: 516-280-4907
Mailing address:
  • Phone: 516-280-8111
  • Fax: 516-280-4907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. RAKESH MEHTA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 607-232-2834