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General NPI Number Information
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NPI Number | 1942550603
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Entity Type | Organization
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Legal Business Name | SUNDANCE SADC INC.
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 486 LIVONIA AVE.
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City | BROOKLYN
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State | NY
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Zip | 11207
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Country | US
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Telephone | 929-234-2900
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Fax | 718-889-2349
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Provider Business Mailing Address
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Address Line | 561 UTICA AVE FL 2
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City | BROOKLYN
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State | NY
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Zip | 11203-1916
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Country | US
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Telephone | 929-234-2901
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STEVEN METELSKY
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Credential |
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Telephone | 929-234-2900
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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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