MEDICARE: GOLDEN YEARS ADULT CARE, 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

General Provider Information

NPI Number	:	1558607184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN YEARS ADULT CARE, LLC

Provider Business Mailing Address
First Line	:	6301 MILL LN
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5512
Country	:	US
Telephone Number	:	646-326-9971
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 MILL LN
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5512
Country	:	US
Telephone Number	:	646-326-9971
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. BRADLEY BAILYN
Credential	:
Telephone Number	:	646-326-9971

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	12/31/2012

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