Provider Demographics
NPI:1184398661
Name:ADVANCED ADULT DAY HEALTH CENTER LLC
Entity type:Organization
Organization Name:ADVANCED ADULT DAY HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/COO DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MPC, MBA
Authorized Official - Phone:804-317-7777
Mailing Address - Street 1:4324 FOX TROTTER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-2349
Mailing Address - Country:US
Mailing Address - Phone:804-317-7777
Mailing Address - Fax:804-648-7777
Practice Address - Street 1:7193 BROOKING WAY
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-5059
Practice Address - Country:US
Practice Address - Phone:804-317-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care