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General NPI Number Information
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NPI Number | 1518612514
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Entity Type | Organization
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Legal Business Name | GREAT HOME ADULT DAYCARE CENTER INC
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 136-41 41ST AVENUE UNIT C1B
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City | FLUSHING
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State | NY
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Zip | 11355
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Country | US
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Telephone | 718-321-0658
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Fax | 718-321-0149
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Provider Business Mailing Address
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Address Line | 136-41 41ST AVENUE UNIT C1B
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City | FLUSHING
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State | NY
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Zip | 11355
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Country | US
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Telephone | 718-321-0658
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. JING HUANG-ZHENG
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Credential |
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Telephone | 718-321-0658
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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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