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General NPI Number Information
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NPI Number | 1225655343
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Entity Type | Organization
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Legal Business Name | FOREVER YOUNG MEDICAL DAY CARE
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 18 WORLDS FAIR DR FL 1
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City | SOMERSET
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State | NJ
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Zip | 08873-1346
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Country | US
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Telephone | 732-939-9512
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Fax | 732-271-8116
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Provider Business Mailing Address
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Address Line | 18 WORLDS FAIR DR FL 1
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City | SOMERSET
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State | NJ
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Zip | 08873-1346
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Country | US
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Telephone | 732-939-9512
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Fax | 732-271-8116
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Authorized Official
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Title or Position | PARTNER - MANAGER
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Name | MARIYA TOLCHEVA
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Credential |
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Telephone | 732-939-9512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #3
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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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