| NPI | 1982962726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUANGJUN XU Director 718-939-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2019-04-02 |