Organization
GOLDEN YEARS ADULT DAY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYUBOV ILIACHINE (OWNER)
(973) 782-4112
Entity
Organization
Contact information
Practice address
1225 MCBRIDE AVE, WOODLAND PARK, NJ 07424-3812
(973) 783-4112
(973) 782-4116
Mailing address
1225 MCBRIDE AVE STE 208, WOODLAND PARK, NJ 07424-3813
(973) 783-4112
(973) 782-4116
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
PQGG17
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8797706
—
NJ
Enumeration date
03/22/2007
Last updated
09/16/2020
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