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General NPI Number Information
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NPI Number | 1487052346
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Entity Type | Organization
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Legal Business Name | NEW AGE ADULT DAY CARE SERVICES, LLC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 55 BUCK RD SUITE 12
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-1501
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Country | US
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Telephone | 215-518-9998
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Fax | 215-396-6650
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Provider Business Mailing Address
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Address Line | 55 BUCK RD SUITE 12
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-1501
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Country | US
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Telephone | 215-518-9998
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Fax | 215-396-6650
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Authorized Official
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Title or Position | NURSING SUPERVISOR
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Name | YELENA MARMUR
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Credential |
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Telephone | 215-518-9998
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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 | 295424
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License Number State | PA
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