Provider Demographics
NPI:1760746119
Name:LY EAST FLUSHING ADULT CARE INC
Entity Type:Organization
Organization Name:LY EAST FLUSHING ADULT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:XIAO
Authorized Official - Middle Name:PING
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-801-7833
Mailing Address - Street 1:4519 162ND ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3137
Mailing Address - Country:US
Mailing Address - Phone:718-801-7833
Mailing Address - Fax:
Practice Address - Street 1:4519 162ND ST STE 1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3137
Practice Address - Country:US
Practice Address - Phone:718-801-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-30
Last Update Date:2012-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care