Provider Demographics
NPI:1295183135
Name:AMERICAN ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:AMERICAN ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:O'NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:407-963-5638
Mailing Address - Street 1:2342 VICTORIA FALLS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4314
Mailing Address - Country:US
Mailing Address - Phone:407-963-5638
Mailing Address - Fax:407-278-4020
Practice Address - Street 1:2342 VICTORIA FALLS DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-4314
Practice Address - Country:US
Practice Address - Phone:407-963-5638
Practice Address - Fax:407-278-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care