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General NPI Number Information
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NPI Number | 1629568712
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Entity Type | Organization
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Legal Business Name | DG CULTURAL CENTER, INC.
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 150 JAMES WAY
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-3818
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Country | US
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Telephone | 215-518-9998
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Fax |
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Provider Business Mailing Address
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Address Line | 38 GLENFIELD DR
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City | RICHBORO
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State | PA
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Zip | 18954-1315
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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 | PRESIDENT
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Name | DAVID GVINIANIDZE
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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 |
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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 |
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License Number State |
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