Provider Demographics
NPI:1134092836
Name:120 AND BEYOND SOCIAL ADULT DAY CARE, LLC
Entity type:Organization
Organization Name:120 AND BEYOND SOCIAL ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PINHAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAVAKOLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-718-3120
Mailing Address - Street 1:801 MIDDLE NECK RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-1932
Practice Address - Country:US
Practice Address - Phone:516-718-3120
Practice Address - Fax:516-718-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care