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General NPI Number Information
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NPI Number | 1548737240
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Entity Type | Organization
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Legal Business Name | IRVINGTON ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 62-70 HOWARD STREET
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 862-285-2449
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Fax | 862-772-4376
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Provider Business Mailing Address
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Address Line | 62-70 HOWARD STREET
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 862-285-2449
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Fax | 862-772-4376
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Authorized Official
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Title or Position | CONSULTANT
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Name | KAILASH GUPTA
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Credential |
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Telephone | 201-803-3072
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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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