Healthcare Provider Details

I. General information

NPI: 1568904076
Provider Name (Legal Business Name): ACTIVE ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3296 PALISADES CENTER DR
WEST NYACK NY
10994-6602
US

IV. Provider business mailing address

3296 PALISADES CENTER DR
WEST NYACK NY
10994-6602
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-7779
  • Fax:
Mailing address:
  • Phone: 845-354-7779
  • 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: RICHARD SERRANO
Title or Position: OWNER
Credential: PT
Phone: 845-354-7779