Provider Demographics
NPI:1114266178
Name:RISING STAR ADULT DAY CARE CENTER LLC
Entity Type:Organization
Organization Name:RISING STAR ADULT DAY CARE CENTER LLC
Other - Org Name:RISING STAR ADULT MEDICAL DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SEJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DASONDI
Authorized Official - Suffix:
Authorized Official - Credentials:CALA
Authorized Official - Phone:732-207-0610
Mailing Address - Street 1:22 MERIDIAN RD
Mailing Address - Street 2:SUITE #10
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2860
Mailing Address - Country:US
Mailing Address - Phone:732-951-2020
Mailing Address - Fax:732-951-2307
Practice Address - Street 1:1980 N OLDEN AVENUE EXT
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2116
Practice Address - Country:US
Practice Address - Phone:732-979-4512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11007261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care