Healthcare Provider Details

I. General information

NPI: 1477051209
Provider Name (Legal Business Name): RICHMOND HILL ADULT DAY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13011 LIBERTY AVE
SOUTH RICHMOND HILL NY
11419-3121
US

IV. Provider business mailing address

9501 125TH ST
SOUTH RICHMOND HILL NY
11419-1436
US

V. Phone/Fax

Practice location:
  • Phone: 347-484-0565
  • Fax: 718-843-2192
Mailing address:
  • Phone: 347-484-0565
  • 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. VISHNU R MAHADEO
Title or Position: EXECUTIVE DIRECTOR
Credential: B SC. / EDFP
Phone: 347-484-0565