Healthcare Provider Details

I. General information

NPI: 1144653197
Provider Name (Legal Business Name): ALBERT SENIOR DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 WILLOW AVE STE D
ELKINS PARK PA
19027-3106
US

IV. Provider business mailing address

1400 WILLOW AVE STE D
ELKINS PARK PA
19027-3106
US

V. Phone/Fax

Practice location:
  • Phone: 267-304-8128
  • Fax:
Mailing address:
  • Phone: 267-304-8128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number285174
License Number StatePA

VIII. Authorized Official

Name: MR. WHA YOUNG KIM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 267-304-8128