Provider Demographics
NPI:1407474760
Name:NYGOOD ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:NYGOOD ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-867-4778
Mailing Address - Street 1:4055 COLLEGE POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5169
Mailing Address - Country:US
Mailing Address - Phone:845-867-4778
Mailing Address - Fax:
Practice Address - Street 1:4055 COLLEGE POINT BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5169
Practice Address - Country:US
Practice Address - Phone:845-867-4778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health