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Organization
AWAY FROM HOME SENIOR DAY CARE
Active
Organization
AWAY FROM HOME SENIOR DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELISA MIRIAM BELLIDO (CEO)
(917) 796-5622
Entity
Organization
Contact information
Practice address
1500 ROUTE 112, BUILDING 6, SUITE A, PORT JEFFERSON STATION, NY 11776-8054
(917) 796-5622
Mailing address
31 JANET ST, PORT JEFFERSON STATION, NY 11776-3613
(917) 796-5622
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
NULL
311Z00000X
Custodial Care Facility
—
NULL
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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