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Organization

NORTHEAST ADULT DAY CARE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VLADA RUBARKH RN (PRESIDENT)
(215) 671-0200
Entity
Organization

Contact information

Practice address
11048 RENNARD ST, PHILADELPHIA, PA 19116-2618
(215) 671-0200
(215) 671-0686
Mailing address
11048 RENNARD ST, PHILADELPHIA, PA 19116-2618
(215) 671-0200
(215) 671-0686

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
332S00000X
Hearing Aid Equipment
D00771
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007686610006
PA
05
1225106222
PA
Enumeration date
11/30/2006
Last updated
06/08/2023
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