Organization
FOREVER YOUNG II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VLADISLAV TOLCHEV (OWNER)
(732) 939-9512
Entity
Organization
Contact information
Practice address
55 E 175 ST, BRONX, NY 10453
(732) 939-1512
Mailing address
55 E 175 ST, BRONX, NY 10453
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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