Provider Demographics
NPI:1053850735
Name:PARADISE ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:PARADISE ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREPELITSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-436-2112
Mailing Address - Street 1:5506 CHURCH AVE
Mailing Address - Street 2:NUMBER 10
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3718
Mailing Address - Country:US
Mailing Address - Phone:347-436-2112
Mailing Address - Fax:718-307-7511
Practice Address - Street 1:5506 CHURCH AVE
Practice Address - Street 2:NUMBER 10
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3718
Practice Address - Country:US
Practice Address - Phone:347-436-2112
Practice Address - Fax:718-307-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care