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General NPI Number Information
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NPI Number | 1972283232
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Entity Type | Organization
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Legal Business Name | GARDEN STATE ADULT MEDICAL DAY CARE CENTER LLC
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 20 MEADOWLANDS PKWY
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City | SECAUCUS
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State | NJ
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Zip | 07094-2944
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Country | US
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Telephone | 201-407-9757
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MCKITTRICK CT
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7228
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Country | US
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Telephone | 201-407-9757
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | NILAM TRIVEDI
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Credential |
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Telephone | 201-407-9757
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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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