Provider Demographics
NPI:1689051732
Name:PRINCETON ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:PRINCETON ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRUKH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOVINDAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-577-0588
Mailing Address - Street 1:2245 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:SOUTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08810
Mailing Address - Country:US
Mailing Address - Phone:609-577-0588
Mailing Address - Fax:732-584-2432
Practice Address - Street 1:2245 ROUTE 130
Practice Address - Street 2:
Practice Address - City:SOUTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08810
Practice Address - Country:US
Practice Address - Phone:609-577-0588
Practice Address - Fax:732-584-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home