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General NPI Number Information
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NPI Number | 1710493796
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Entity Type | Organization
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Legal Business Name | SUMMIT ADULT DAYCARE, INC.
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 12/28/2017
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Provider Practice Location Address
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Address Line | 178-02/04, JAMAICA AVE., JAMAICA, NY 11432
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City | QUEENS
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State | NY
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Zip | 11435
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Country | US
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Telephone | 347-969-6243
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Fax |
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Provider Business Mailing Address
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Address Line | 8606 148TH ST FL 1
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City | JAMAICA
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State | NY
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Zip | 11435-3116
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Country | US
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Telephone | 347-969-6243
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS MARIJKE JAGMOHAN
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Credential |
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Telephone | 347-969-6243
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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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