Provider Demographics
NPI:1629260377
Name:ADULT DAY CARE CORP
Entity Type:Organization
Organization Name:ADULT DAY CARE CORP
Other - Org Name:ATLANTIC ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAZIMIROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-255-7555
Mailing Address - Street 1:1122 DR MARY MCLEOD BETHUNE BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2934
Mailing Address - Country:US
Mailing Address - Phone:386-255-7555
Mailing Address - Fax:
Practice Address - Street 1:1122 DR MARY MCLEOD BETHUNE BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2934
Practice Address - Country:US
Practice Address - Phone:386-255-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)