Healthcare Provider Details

I. General information

NPI: 1114204401
Provider Name (Legal Business Name): SILVER TOWN ADULT DAY CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25021 NORTHERN BLVD
LITTLE NECK NY
11362-1353
US

IV. Provider business mailing address

25021 NORTHERN BLVD
LITTLE NECK NY
11362-1353
US

V. Phone/Fax

Practice location:
  • Phone: 718-631-7979
  • Fax: 718-631-1017
Mailing address:
  • Phone: 718-631-7979
  • Fax: 718-631-1017

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: MR. YONG LEE
Title or Position: PRESIDENT
Credential:
Phone: 718-631-7979