Healthcare Provider Details

I. General information

NPI: 1457886673
Provider Name (Legal Business Name): LENA'S ADULT DAY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 04/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 BLUEBIRD RD
SOUTH GLENS FALLS NY
12803-5010
US

IV. Provider business mailing address

230 BLUEBIRD RD
SOUTH GLENS FALLS NY
12803-5010
US

V. Phone/Fax

Practice location:
  • Phone: 518-792-7797
  • Fax: 518-792-7797
Mailing address:
  • Phone: 518-792-7797
  • Fax: 518-792-7797

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: PETER BONDZINSKI
Title or Position: PRESIDENT
Credential:
Phone: 518-793-7177