Provider Demographics
NPI:1093214488
Name:KINGS ADULT CARE CENTER, LLC
Entity Type:Organization
Organization Name:KINGS ADULT CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIFSCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-238-4118
Mailing Address - Street 1:2255 CROPSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5705
Mailing Address - Country:US
Mailing Address - Phone:718-266-5858
Mailing Address - Fax:718-266-6157
Practice Address - Street 1:2255 CROPSEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5705
Practice Address - Country:US
Practice Address - Phone:718-266-5858
Practice Address - Fax:718-266-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331-F-281310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility