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General NPI Number Information
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NPI Number | 1689104549
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Entity Type | Organization
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Legal Business Name | GENERATIONS ADULT DAY CARE
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 110 E BROADWAY
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City | MONTICELLO
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State | NY
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Zip | 12701-8815
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Country | US
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Telephone | 845-292-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | LIBERTY
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State | NY
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Zip | 12754-0127
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Country | US
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Telephone | 914-799-4557
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Fax |
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Authorized Official
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Title or Position | ATTORNEY
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Name | SERGIO A SARAVIA
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Credential |
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Telephone | 845-292-0000
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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 | NY
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