Organization
DERVISH SOCIAL ADULT DAY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BADEN-AHMED NP (EXCITIVE DIRECTOR)
(347) 925-8914
Entity
Organization
Contact information
Practice address
2060 WALLACE AVE, BRONX, NY 10462-3006
(929) 293-4579
(718) 421-0003
Mailing address
614 RICHMOND RD, STATEN ISLAND, NY 10304-2410
(929) 293-4579
(718) 421-0003
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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