MEDICARE: SWEET FAMILY ADULT DAY CARE INC

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	:	1730849704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEET FAMILY ADULT DAY CARE INC

Provider Business Mailing Address
First Line	:	3759 81ST ST FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-6977
Country	:	US
Telephone Number	:	917-881-5868
Fax Number	:

Provider Business Practice Location Address
First Line	:	3759 81ST ST FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-6977
Country	:	US
Telephone Number	:	917-881-5868
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JASON FANG
Credential	:
Telephone Number	:	917-881-5868

Provider Enumeration Date	:	12/17/2021
Last Update Date	:	12/21/2021

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