Provider Demographics
NPI:1972362853
Name:GRANDVIDA ADULT DAY CARE INC.
Entity Type:Organization
Organization Name:GRANDVIDA ADULT DAY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUANLUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZA
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:845-636-0687
Mailing Address - Street 1:34 PETERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4438
Mailing Address - Country:US
Mailing Address - Phone:845-636-0687
Mailing Address - Fax:
Practice Address - Street 1:3485 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2016
Practice Address - Country:US
Practice Address - Phone:718-828-1549
Practice Address - Fax:718-828-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care