Provider Demographics
NPI:1255850608
Name:C R E ADULT DAY CARE CENTER INC.
Entity Type:Organization
Organization Name:C R E ADULT DAY CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAO WU
Authorized Official - Middle Name:
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-592-1221
Mailing Address - Street 1:9815 HORACE HARDING EXPY STE 1M
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4249
Mailing Address - Country:US
Mailing Address - Phone:718-592-1221
Mailing Address - Fax:718-592-1229
Practice Address - Street 1:9815 HORACE HARDING EXPY STE 1M
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4249
Practice Address - Country:US
Practice Address - Phone:718-592-1221
Practice Address - Fax:718-592-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization