Provider Demographics
NPI:1992041230
Name:BERGEN COUNTY ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:BERGEN COUNTY ADULT DAY CARE LLC
Other - Org Name:NEW LIFE ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-265-0606
Mailing Address - Street 1:340 EVELYN ST
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2908
Mailing Address - Country:US
Mailing Address - Phone:201-265-0606
Mailing Address - Fax:201-265-0630
Practice Address - Street 1:340 EVELYN ST
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2908
Practice Address - Country:US
Practice Address - Phone:201-265-0606
Practice Address - Fax:201-265-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJI5W32J261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care