Healthcare Provider Details

I. General information

NPI: 1609347996
Provider Name (Legal Business Name): ALWAYS YOUNG AT HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 N BROADWAY
SLEEPY HOLLOW NY
10591-2609
US

IV. Provider business mailing address

PO BOX 18
HARRISON NY
10528-0018
US

V. Phone/Fax

Practice location:
  • Phone: 914-572-0272
  • 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: RIDA ABI-HABIB
Title or Position: PRESIDENT
Credential:
Phone: 914-572-0272