Organization Name: | JAY SHREE KRISHNA MOONACHIE LLC |
NPI Number: | 1992045405 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PARUL V SHAH (MEMBER) |
Mailing Address: | 311 E Park St Moonachie |
State: | NJ US |
Postal Code: | 070741138 |
Phone Number: | 9732025072 |
Fax Number: | 9738823162 |
NPI Enumeration Date: | 02/20/2013 |
NPI Last Update Date: | 02/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |