Provider Demographics
NPI:1932443306
Name:TREMONT ADULT DAYCARE, INC
Entity Type:Organization
Organization Name:TREMONT ADULT DAYCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-926-4134
Mailing Address - Street 1:901 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4301
Mailing Address - Country:US
Mailing Address - Phone:347-537-5222
Mailing Address - Fax:718-764-4338
Practice Address - Street 1:901 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4301
Practice Address - Country:US
Practice Address - Phone:347-537-5222
Practice Address - Fax:718-764-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-24
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X, 311ZA0620X
NY261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home