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General NPI Number Information
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NPI Number | 1255940052
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Entity Type | Organization
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Legal Business Name | GOOD FAITH SOCIAL DAYCARE
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 1385 BAY ST
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3901
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Country | US
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Telephone | 718-876-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 1385 BAY ST
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3901
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Country | US
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Telephone | 718-876-0900
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KYTH TRIEU
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Credential |
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Telephone | 347-302-7744
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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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