Provider Demographics
NPI:1396497772
Name:LOVELY ADULT DAY CARE,LLC
Entity type:Organization
Organization Name:LOVELY ADULT DAY CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENTS' SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOVELY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEUDY-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-818-5428
Mailing Address - Street 1:2 PERLMAN DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5230
Mailing Address - Country:US
Mailing Address - Phone:845-793-9497
Mailing Address - Fax:845-352-1045
Practice Address - Street 1:2 PERLMAN DR STE 301
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5230
Practice Address - Country:US
Practice Address - Phone:845-793-9497
Practice Address - Fax:845-352-1045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03233901Medicaid
NY1013178482Medicaid