Healthcare Provider Details

I. General information

NPI: 1033827357
Provider Name (Legal Business Name): LANCASTER ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 PRIMROSE LN
MOUNTVILLE PA
17554-1262
US

IV. Provider business mailing address

306 PRIMROSE LN
MOUNTVILLE PA
17554-1262
US

V. Phone/Fax

Practice location:
  • Phone: 717-522-1816
  • Fax: 717-522-1822
Mailing address:
  • Phone: 717-522-1816
  • Fax: 717-522-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. DADI KAFLEY
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 717-522-1816