Provider Demographics
NPI:1023452141
Name:DITMAS PARK ADULT DAY CARE LLC
Entity type:Organization
Organization Name:DITMAS PARK ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-907-8560
Mailing Address - Street 1:2107 DITMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:464 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6902
Practice Address - Country:US
Practice Address - Phone:718-907-8560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility