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NPI Code Detail

MEDICARE: KINGS ADULT CARE CENTER, LLC

MEDICARE: KINGS ADULT CARE CENTER, 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
1310400000XAssisted Living Facility331-F-281NY

General Provider Information

NPI Number : 1093214488
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINGS ADULT CARE CENTER, LLC
Provider Business Mailing Address
First Line : 2255 CROPSEY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5705
Country : US
Telephone Number : 718-266-5858
Fax Number : 718-266-6157
Provider Business Practice Location Address
First Line : 2255 CROPSEY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5705
Country : US
Telephone Number : 718-266-5858
Fax Number : 718-266-6157
Authorized Official
Title or Position : OPERATOR, ADMINISTRATOR
Name : DANIEL LIFSCHUTZ
Credential :
Telephone Number : 516-238-4118
Provider Enumeration Date : 02/12/2018
Last Update Date : 02/12/2018

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