Provider Demographics
NPI:1790226017
Name:RADHA ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:RADHA ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-906-7203
Mailing Address - Street 1:330 BLACK HORSE PIKE
Mailing Address - Street 2:UNIT B
Mailing Address - City:GLENDORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08029-1439
Mailing Address - Country:US
Mailing Address - Phone:856-931-0753
Mailing Address - Fax:732-960-2360
Practice Address - Street 1:316 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:NJ
Practice Address - Zip Code:08029-1476
Practice Address - Country:US
Practice Address - Phone:856-313-6741
Practice Address - Fax:732-960-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ04017310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility