Provider Demographics
NPI:1528403409
Name:DAYSCAPE ADULT CARE CENTER INC.
Entity Type:Organization
Organization Name:DAYSCAPE ADULT CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EICHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-531-1771
Mailing Address - Street 1:4800 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4371
Mailing Address - Country:US
Mailing Address - Phone:954-531-1771
Mailing Address - Fax:954-531-1781
Practice Address - Street 1:4800 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 13
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4371
Practice Address - Country:US
Practice Address - Phone:954-531-1771
Practice Address - Fax:954-531-1781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9131261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid