Provider Demographics
NPI:1063801991
Name:ENIGMA ADULT DAY CARE CENTER
Entity type:Organization
Organization Name:ENIGMA ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOKKO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:646-920-5244
Mailing Address - Street 1:33 -11A 74TH STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSON HGTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372
Mailing Address - Country:US
Mailing Address - Phone:646-920-5244
Mailing Address - Fax:
Practice Address - Street 1:33-11A 74TH STREET
Practice Address - Street 2:
Practice Address - City:JACKSON HGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372
Practice Address - Country:US
Practice Address - Phone:646-920-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care