Healthcare Provider Details

I. General information

NPI: 1457787228
Provider Name (Legal Business Name): SUNSHINE ADULT SOCIAL DAY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 BROADWAY ST.
NEWBURGH NY
12550
US

IV. Provider business mailing address

608 BROADWAY ST.
NEWBURGH NY
12550
US

V. Phone/Fax

Practice location:
  • Phone: 845-473-6900
  • Fax:
Mailing address:
  • Phone: 845-473-6900
  • 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. CHAIM LIEBERMAN
Title or Position: ADMIN
Credential:
Phone: 845-537-6004