Provider Demographics
NPI:1033827357
Name:LANCASTER ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:LANCASTER ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DADI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAFLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-522-1816
Mailing Address - Street 1:306 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1262
Mailing Address - Country:US
Mailing Address - Phone:717-522-1816
Mailing Address - Fax:717-522-1822
Practice Address - Street 1:306 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:MOUNTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17554-1262
Practice Address - Country:US
Practice Address - Phone:717-522-1816
Practice Address - Fax:717-522-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104054782-0001Medicaid