Provider Demographics
NPI:1346492717
Name:ADL SENIOR CHOICE INC.
Entity Type:Organization
Organization Name:ADL SENIOR CHOICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-205-7144
Mailing Address - Street 1:9520 63RD RD STE T
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1145
Mailing Address - Country:US
Mailing Address - Phone:718-205-7144
Mailing Address - Fax:718-205-7146
Practice Address - Street 1:9520 63RD RD STE T
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1145
Practice Address - Country:US
Practice Address - Phone:718-205-7144
Practice Address - Fax:718-205-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1313L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health