Healthcare Provider Details

I. General information

NPI: 1205233111
Provider Name (Legal Business Name): GOOD FAITH ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106-45 160TH STREET
JAMAICA NY
11433
US

IV. Provider business mailing address

95 BAY 38TH ST 3RD FLOOR
BROOKLYN NY
11214-5319
US

V. Phone/Fax

Practice location:
  • Phone: 646-833-6550
  • Fax:
Mailing address:
  • Phone: 646-833-6550
  • 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: MRS. CHRISTINE CHAN
Title or Position: PRESIDENT
Credential:
Phone: 646-833-6550