Healthcare Provider Details

I. General information

NPI: 1891228052
Provider Name (Legal Business Name): ROCKGATE SOCIAL DAYCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 CROSS ST
WESTBURY NY
11590-2304
US

IV. Provider business mailing address

327 CROSS ST
WESTBURY NY
11590-2304
US

V. Phone/Fax

Practice location:
  • Phone: 347-645-5790
  • Fax:
Mailing address:
  • Phone: 347-645-5790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2017011913144756890
License Number StateNY

VIII. Authorized Official

Name: MRS. CHARMAINE ANEITA MOSES
Title or Position: DIRECTOR
Credential:
Phone: 347-645-5790