Provider Demographics
NPI:1316269152
Name:NEW JERSEY ADULT MEDICAL DAY CARE, INC.
Entity type:Organization
Organization Name:NEW JERSEY ADULT MEDICAL DAY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-736-5301
Mailing Address - Street 1:22-08 ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2605
Mailing Address - Country:US
Mailing Address - Phone:201-736-5301
Mailing Address - Fax:888-389-5324
Practice Address - Street 1:22-08 ROUTE 208
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2605
Practice Address - Country:US
Practice Address - Phone:201-736-5301
Practice Address - Fax:888-389-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-21
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care