Provider Demographics
NPI:1215411053
Name:HAPPY ADULT DAY CARE NY LLC
Entity Type:Organization
Organization Name:HAPPY ADULT DAY CARE NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PYONG
Authorized Official - Middle Name:S
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-614-7000
Mailing Address - Street 1:14218 38TH AVE STE CFD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5554
Mailing Address - Country:US
Mailing Address - Phone:718-886-8836
Mailing Address - Fax:718-886-8177
Practice Address - Street 1:13639 37TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4110
Practice Address - Country:US
Practice Address - Phone:718-886-8836
Practice Address - Fax:718-886-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherMANAGED LONG-TERM CARE