Healthcare Provider Details

I. General information

NPI: 1831739382
Provider Name (Legal Business Name): SPRINGFIELD ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 AVENUE B FL 1
NEW YORK NY
10009-3691
US

IV. Provider business mailing address

602 EAST 12TH STREET, FL 1
NEW YORK NY
10009
US

V. Phone/Fax

Practice location:
  • Phone: 917-836-7761
  • Fax:
Mailing address:
  • Phone:
  • 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: MR. BAO LI ZHANG
Title or Position: DIRECTOR
Credential:
Phone: 917-836-7761