Healthcare Provider Details

I. General information

NPI: 1184297947
Provider Name (Legal Business Name): W GROUP DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11502 OCEAN PROMENADE
ROCKAWAY PARK NY
11694-2412
US

IV. Provider business mailing address

2357 60TH ST
BROOKLYN NY
11204-2689
US

V. Phone/Fax

Practice location:
  • Phone: 347-721-0426
  • Fax:
Mailing address:
  • Phone: 718-841-8000
  • 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: CHARLES SCHONBERGER
Title or Position: ADMINISTRATOR
Credential:
Phone: 347-721-0426