Healthcare Provider Details

I. General information

NPI: 1720917032
Provider Name (Legal Business Name): THE JUBILEE CLUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 HAVERSTRAW RD
SUFFERN NY
10901-3140
US

IV. Provider business mailing address

506 HAVERSTRAW RD
SUFFERN NY
10901-3140
US

V. Phone/Fax

Practice location:
  • Phone: 845-208-9907
  • Fax:
Mailing address:
  • Phone: 845-208-9907
  • 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: ANNA ROSE PALOMARES
Title or Position: OWNER
Credential: RN
Phone: 845-208-9907