Provider Demographics
NPI:1689042582
Name:ADULT DAYCARE CENTER OF ALTAMONTE SPRINGS INC
Entity Type:Organization
Organization Name:ADULT DAYCARE CENTER OF ALTAMONTE SPRINGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-636-6321
Mailing Address - Street 1:1329 E ALTAMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5011
Mailing Address - Country:US
Mailing Address - Phone:407-636-6321
Mailing Address - Fax:321-445-4740
Practice Address - Street 1:1329 E ALTAMONTE DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5011
Practice Address - Country:US
Practice Address - Phone:407-636-6321
Practice Address - Fax:321-445-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9323261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care