NPIMap

Organization Active NPI

Split Rock Adult Day Health Care

  • Adult Day Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1275733297
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
7000384N Issued in NY
Legal business name
SPLIT ROCK ADULT DAY HEALTH CARE
Practice address
3525 Baychester Ave
Bronx, NY 10466-5001
Phone
(718) 798-8900
Fax
(855) 570-0752
NPI assigned
Jul 18, 2007
Last updated
Apr 16, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SPLIT ROCK NURSING AND REHABAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Aj Weiss
Title
Controller
Phone
(718) 670-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 7000384N NY Primary

Addresses

Primary practice location

3525 Baychester Ave
Bronx, NY 10466-5001

Mailing address

3525 Baychester Ave
Bronx, NY 10466-5001
Phone (718) 798-8900

Other identifiers 1

IdentifierTypeStateIssuer
01120103MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Split Rock Rehabilitation Health Care Center LLC4 organizations share this tax ID, including this one
Part of
Split Rock Rehabilitation Health Care Center LLC

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": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1275733297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 BAYCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104665001",
            "telephone_number": "718-798-8900",
            "fax_number": "855-570-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 BAYCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104665001",
            "telephone_number": "718-798-8900",
            "fax_number": "855-570-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPLIT ROCK ADULT DAY HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPLIT ROCK NURSING AND REHAB",
        "enumeration_date": "2007-07-18",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "718-670-6300"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NY",
            "license": "7000384N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01120103",
            "state": "NY"
        }
    ],
    "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 Apr 16, 2015; 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.