Provider Demographics
NPI:1518333269
Name:SEPHORA ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:SEPHORA ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:ADOLPHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-984-1999
Mailing Address - Street 1:1763 E 48TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3705
Mailing Address - Country:US
Mailing Address - Phone:347-984-1999
Mailing Address - Fax:
Practice Address - Street 1:1763 E 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3705
Practice Address - Country:US
Practice Address - Phone:347-984-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care