NPI 1720326077

Away From Home Senior Day Care

Organisation Alzheimer Center (Dementia Center) Port Jefferson Station, NY

Practice location

Address: 1500 Route 112 Building 6, Suite a, Port Jefferson Station, NY 11776-8054
Phone: (917) 796-5622
Mailing address: 31 Janet St, Port Jefferson Station, NY 11776-3613

Authorised official

Name: Elisa Miriam Bellido
Title: Ceo
Phone: (917) 796-5622

Registered specialties (2)

Alzheimer Center (Dementia Center) Primary

Nursing & Custodial Care Facilities Taxonomy 311500000X

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Custodial Care Facility

Nursing & Custodial Care Facilities Taxonomy 311Z00000X

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Registry record

NPI: 1720326077
Entity type: Organization
NPI issued: 22 Jan 2013
Record last updated: 22 Jan 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.