Provider Demographics
NPI:1710493796
Name:SUMMIT ADULT DAYCARE, INC.
Entity Type:Organization
Organization Name:SUMMIT ADULT DAYCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIJKE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGMOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-969-6243
Mailing Address - Street 1:8606 148TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3116
Mailing Address - Country:US
Mailing Address - Phone:347-969-6243
Mailing Address - Fax:
Practice Address - Street 1:178-02/04, JAMAICA AVE., JAMAICA, NY 11432
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:347-969-6243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care