Provider Demographics
NPI:1821307745
Name:SHOLOM DAY CARE
Entity Type:Organization
Organization Name:SHOLOM DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-850-2934
Mailing Address - Street 1:11666 PARK LN S
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1020
Mailing Address - Country:US
Mailing Address - Phone:718-850-2934
Mailing Address - Fax:718-849-0521
Practice Address - Street 1:11666 PARK LN S
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1020
Practice Address - Country:US
Practice Address - Phone:718-850-2934
Practice Address - Fax:718-849-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services