Provider Demographics
NPI:1609178938
Name:ADULTCARE INC. SOCIAL DAYCARE PROGRAM
Entity Type:Organization
Organization Name:ADULTCARE INC. SOCIAL DAYCARE PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARCHEVALD
Authorized Official - Suffix:
Authorized Official - Credentials:CALA
Authorized Official - Phone:201-864-5400
Mailing Address - Street 1:1607 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5417
Mailing Address - Country:US
Mailing Address - Phone:201-864-5400
Mailing Address - Fax:201-864-1512
Practice Address - Street 1:1607 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5417
Practice Address - Country:US
Practice Address - Phone:201-864-5400
Practice Address - Fax:201-864-1512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care