Provider Demographics
NPI:1598326985
Name:WYNDMOOR ADULT DAY CARE COMPANY LLC
Entity Type:Organization
Organization Name:WYNDMOOR ADULT DAY CARE COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-831-7622
Mailing Address - Street 1:551 E EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:551 E EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-8321
Practice Address - Country:US
Practice Address - Phone:215-233-6309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care