Provider Demographics
NPI:1275048035
Name:OM ADULT DAY CARE CENTER OF NY LLC
Entity Type:Organization
Organization Name:OM ADULT DAY CARE CENTER OF NY LLC
Other - Org Name:OM SOCIAL ADULT DAY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEMANG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-766-5899
Mailing Address - Street 1:13005 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1519
Mailing Address - Country:US
Mailing Address - Phone:347-537-5995
Mailing Address - Fax:
Practice Address - Street 1:13005 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1519
Practice Address - Country:US
Practice Address - Phone:347-537-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OM SOCIAL ADULT DAY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care