Provider Demographics
NPI:1396305827
Name:N & J ADULT DAY CARE LLC
Entity type:Organization
Organization Name:N & J ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES BANGUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-381-0465
Mailing Address - Street 1:9340 N FLORIDA AVE STE E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7925
Mailing Address - Country:US
Mailing Address - Phone:813-381-0465
Mailing Address - Fax:
Practice Address - Street 1:9340 N FLORIDA AVE STE E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7925
Practice Address - Country:US
Practice Address - Phone:813-381-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care