Provider Demographics
NPI:1629424510
Name:SOH TRANSIT LLC
Entity Type:Organization
Organization Name:SOH TRANSIT LLC
Other - Org Name:BOOM BOOM ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-551-8207
Mailing Address - Street 1:14218 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5526
Mailing Address - Country:US
Mailing Address - Phone:718-551-8207
Mailing Address - Fax:718-228-3773
Practice Address - Street 1:14218 38TH AVE STE CFD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-551-8207
Practice Address - Fax:718-228-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care