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General NPI Number Information
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NPI Number | 1023740115
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Entity Type | Organization
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Legal Business Name | IMPRESSIVE DAY CALE LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 3722 73RD ST STE A1
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6273
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Country | US
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Telephone | 718-734-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3722 73RD ST STE A1
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6273
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Country | US
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Telephone | 718-734-5600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SHAHRIAR ARIF
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Credential |
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Telephone | 718-734-5600
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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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