Healthcare Provider Details

I. General information

NPI: 1821348053
Provider Name (Legal Business Name): UNITED ADULT DAY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10344 121ST ST
SOUTH RICHMOND HILL NY
11419-2104
US

IV. Provider business mailing address

103-44 121 STREET
RICHMOND HILL NY
11419
US

V. Phone/Fax

Practice location:
  • Phone: 917-662-8913
  • Fax:
Mailing address:
  • Phone: 917-662-8913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: WEN J CAO
Title or Position: OWNER/FOUNDER
Credential:
Phone: 917-662-8913