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General NPI Number Information
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NPI Number | 1023574746
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Entity Type | Organization
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Legal Business Name | BETWEEN AGES ADULT SOCIAL CENTER
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 175 MEMORIAL HWY STE 1-3
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5639
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Country | US
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Telephone | 914-740-5160
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Fax | 914-740-5161
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Provider Business Mailing Address
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Address Line | 175 MEMORIAL HWY STE 1-3
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5639
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Country | US
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Telephone | 914-740-5160
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Fax | 914-740-5161
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | MRS. MCKEISHA RICHARDSON
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Credential |
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Telephone | 914-223-0553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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