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General NPI Number Information
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NPI Number | 1285051516
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Entity Type | Organization
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Legal Business Name | FOX CHASE ADULT DAY CARE INC.
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1001 VINE ST FL 5
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1321
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Country | US
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Telephone | 267-945-5479
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 VINE ST FL 5
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1321
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Country | US
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Telephone | 267-945-5479
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | VIKTOR SEMENOV
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Credential |
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Telephone | 267-945-5479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 315274
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 315274
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License Number State | PA
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