Healthcare Provider Details

I. General information

NPI: 1023812542
Provider Name (Legal Business Name): BLUE RIBBON SOCIAL ACTIVITY DAY CENTER LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S FRANKLIN ST
HEMPSTEAD NY
11550-7643
US

IV. Provider business mailing address

12110 133RD ST
SOUTH OZONE PARK NY
11420-2913
US

V. Phone/Fax

Practice location:
  • Phone: 202-891-0050
  • Fax:
Mailing address:
  • Phone: 202-891-0050
  • 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: JAMES WOLF
Title or Position: BUSINESS MANAGER
Credential:
Phone: 202-891-0050