MEDICARE: IYAHO ADULT DAY 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	:	1912474727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IYAHO ADULT DAY CARE LLC

Provider Business Mailing Address
First Line	:	2026 WESTCHESTER AVENUE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462
Country	:	US
Telephone Number	:	347-727-4585
Fax Number	:

Provider Business Practice Location Address
First Line	:	2026 WESTCHESTER AVENUE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462
Country	:	US
Telephone Number	:	347-727-4585
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	EHIAVEKHAN EROMOSELE
Credential	:
Telephone Number	:	347-727-4585

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	12/17/2025

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