Healthcare Provider Details

I. General information

NPI: 1053714055
Provider Name (Legal Business Name): NEW LIFE SOCIAL ADULT DAY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 S BROADWAY
YONKERS NY
10705
US

IV. Provider business mailing address

197 S BROADWAY
YONKERS NY
10705
US

V. Phone/Fax

Practice location:
  • Phone: 914-222-0775
  • Fax: 914-470-5628
Mailing address:
  • Phone: 914-222-0775
  • Fax: 914-470-5628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ZHANNA ALERGANT
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 917-734-7430