Provider Demographics
NPI:1700085479
Name:OTRADA ADULT DAY HEALTHCARE CENTER,
Entity Type:Organization
Organization Name:OTRADA ADULT DAY HEALTHCARE CENTER,
Other - Org Name:JOY ADULT DAY HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONG CHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-498-0050
Mailing Address - Street 1:8530 AMANDA PL
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6873
Mailing Address - Country:US
Mailing Address - Phone:703-942-6688
Mailing Address - Fax:
Practice Address - Street 1:8530 AMANDA PL
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-6873
Practice Address - Country:US
Practice Address - Phone:703-992-6688
Practice Address - Fax:703-942-6776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care