=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720845498
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL IN A DAY ADULT MEDICAL DAYACRE-BY EXCELCARELLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/29/2024
-----------------------------------------------------
Last Update Date | 02/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 104 PENSION RD
-----------------------------------------------------
City | MANALAPAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07726-8400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-792-2273
-----------------------------------------------------
Fax | 732-792-2332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 PENSION RD
-----------------------------------------------------
City | MANALAPAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07726-8400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-792-2273
-----------------------------------------------------
Fax | 732-792-2332
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR/DIRECTOR
-----------------------------------------------------
Name | KELLY RAIKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-792-2273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------