Provider Demographics
NPI:1841561172
Name:APOLLO HEALTHCARE LLC
Entity Type:Organization
Organization Name:APOLLO HEALTHCARE LLC
Other - Org Name:GOODLIFE ADULT DAY CARE CENTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-2672
Mailing Address - Street 1:515 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-4010
Mailing Address - Country:US
Mailing Address - Phone:973-674-1500
Mailing Address - Fax:
Practice Address - Street 1:515 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-4010
Practice Address - Country:US
Practice Address - Phone:973-674-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care