Provider Demographics
NPI:1629795737
Name:YANG GUANG ADULT DAYCARE INC.
Entity Type:Organization
Organization Name:YANG GUANG ADULT DAYCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZUQUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-807-1999
Mailing Address - Street 1:3506 LEAVITT ST STE CFE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2967
Mailing Address - Country:US
Mailing Address - Phone:718-762-9100
Mailing Address - Fax:
Practice Address - Street 1:3506 LEAVITT ST STE CFE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2967
Practice Address - Country:US
Practice Address - Phone:718-762-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care