MEDICARE: GENERATIONS ADULT DAY HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	018101	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	018101	OTHER	NJ	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1053456012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERATIONS ADULT DAY HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	40 E NEW YORK AVE
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2341
Country	:	US
Telephone Number	:	609-653-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 E NEW YORK AVE
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2341
Country	:	US
Telephone Number	:	609-653-9700
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER,OWNER,ADMIN
Name	:	MRS. CHRISTA A CALDARALE-AHEARN
Credential	:	RN, MS
Telephone Number	:	609-653-9700

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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