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General NPI Number Information
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NPI Number | 1790278992
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Entity Type | Organization
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Legal Business Name | TLC ADULT DAY CARE LLC.
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 3305 3RD AVE
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City | BRONX
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State | NY
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Zip | 10456-6945
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Country | US
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Telephone | 718-292-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 3RD AVE
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City | BRONX
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State | NY
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Zip | 10456-6945
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Country | US
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Telephone | 718-292-7700
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. JACOB GREEN
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Credential |
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Telephone | 718-292-7700
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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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