Provider Demographics
NPI:1134617855
Name:A PLACE FOR YOU ADULT DAY CARE AND REHAB CENTER CORP.
Entity type:Organization
Organization Name:A PLACE FOR YOU ADULT DAY CARE AND REHAB CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YONIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSHSA, CNP
Authorized Official - Phone:561-965-6980
Mailing Address - Street 1:3678 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3700
Mailing Address - Country:US
Mailing Address - Phone:561-965-6980
Mailing Address - Fax:561-965-9231
Practice Address - Street 1:3678 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3700
Practice Address - Country:US
Practice Address - Phone:561-965-6980
Practice Address - Fax:561-965-9231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009919500Medicaid
FL010295800Medicaid