Provider Demographics
NPI:1114264538
Name:ELDER CARE CENTER, INC
Entity Type:Organization
Organization Name:ELDER CARE CENTER, INC
Other - Org Name:GRACEVILLE SENIORS CLUB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:N
Authorized Official - Last Name:ABID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-743-9000
Mailing Address - Street 1:20 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2162
Mailing Address - Country:US
Mailing Address - Phone:516-743-9000
Mailing Address - Fax:516-743-9004
Practice Address - Street 1:20 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2162
Practice Address - Country:US
Practice Address - Phone:516-743-9000
Practice Address - Fax:516-743-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home