Healthcare Provider Details
I. General information
NPI: 1922774256
Provider Name (Legal Business Name): AMERICAN ADULT DAY CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3-17 E. 116TH STREET GROUND FLOOR
NEW YORK NY
10029-1135
US
IV. Provider business mailing address
13241 41ST RD
FLUSHING NY
11355-4235
US
V. Phone/Fax
- Phone: 646-708-3808
- Fax: 718-445-6688
- Phone: 646-708-3808
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNA
LO
Title or Position: ADMINISTRATOR
Credential:
Phone: 646-708-3808