Healthcare Provider Details

I. General information

NPI: 1043551914
Provider Name (Legal Business Name): LONGEVITY ADULT DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 GRAND ST
NEW YORK NY
10002-4408
US

IV. Provider business mailing address

285 GRAND ST FL 2
NEW YORK NY
10002-4489
US

V. Phone/Fax

Practice location:
  • Phone: 917-373-3641
  • Fax:
Mailing address:
  • Phone: 212-966-1378
  • Fax: 212-320-0686

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: CHUN HU
Title or Position: OWNER
Credential:
Phone: 212-966-1378