Provider Demographics
NPI:1750076956
Name:MOLINA SOCIAL ADULT DAY CARE
Entity type:Organization
Organization Name:MOLINA SOCIAL ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GAJENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-982-3120
Mailing Address - Street 1:3718 73RD ST STE 301
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6218
Mailing Address - Country:US
Mailing Address - Phone:201-982-3120
Mailing Address - Fax:201-489-8035
Practice Address - Street 1:3718 73RD ST STE 301
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6218
Practice Address - Country:US
Practice Address - Phone:201-982-3120
Practice Address - Fax:201-489-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care