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General NPI Number Information
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NPI Number | 1457903437
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Entity Type | Organization
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Legal Business Name | PRIME SOCIAL DAY CARE
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 1918 1ST AVE 1ST FLOOR
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 718-646-1900
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Fax | 718-646-3302
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Provider Business Mailing Address
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Address Line | 3125 EMMONS AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-1724
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Country | US
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Telephone | 718-646-1900
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Fax | 718-646-3302
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Authorized Official
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Title or Position | CFO
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Name | ADRIANA CUESTA
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Credential |
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Telephone | 718-646-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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