Provider Demographics
NPI:1871697417
Name:DAY AT A TIME
Entity type:Organization
Organization Name:DAY AT A TIME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-987-5710
Mailing Address - Street 1:22 VAN DUZER PL
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1014
Mailing Address - Country:US
Mailing Address - Phone:845-987-5710
Mailing Address - Fax:845-987-1398
Practice Address - Street 1:22 VAN DUZER PL
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1014
Practice Address - Country:US
Practice Address - Phone:845-987-5710
Practice Address - Fax:845-987-1398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHERVIER PAVILION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01901308Medicaid