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Organization

HEAVENLY CREATIONS ADULT DAY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MAXINE R HARRIS (DIRECTOR/OWNER)
(917) 226-7249
Entity
Organization

Contact information

Practice address
22008 109TH AVE, QUEENS VILLAGE, NY 11429-2515
(917) 226-7249
Mailing address
22008 109TH AVE, QUEENS VILLAGE, NY 11429-2515
(917) 226-7249

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023377611
NY
Enumeration date
04/15/2014
Last updated
04/15/2014
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