NPIMap

Organization Active NPI

Providence Rest Adult Day Health Care

  • Adult Day Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1063597631
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
7000306N Issued in NY
Legal business name
PROVIDENCE REST ADULT DAY HEALTH CARE
Practice address
3304 Waterbury Ave
Bronx, NY 10465-1554
Phone
(718) 931-3000
Fax
(718) 931-2839
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Sandra Rivera
Title
Cfo
Phone
(718) 931-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 7000306N NY Primary

Addresses

Primary practice location

3304 Waterbury Ave
Bronx, NY 10465-1554

Mailing address

3304 Waterbury Ave
Bronx, NY 10465-1554
Phone (718) 931-3000

National Provider Directory

National Provider Directory
Tax ID family
Providence Rest Outpatient Rehabilitation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063597631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000",
            "fax_number": "718-931-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000",
            "fax_number": "718-931-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE REST ADULT DAY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-931-3000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NY",
            "license": "7000306N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.