C & K 1004 Corp

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

C & K 1004 CORP

Practice address

4525 162ND St
Flushing, NY 11358-3279

Phone

(718) 353-1004

Fax

(718) 374-5953

NPI assigned

Oct 25, 2022

Organization subpart

No

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

Authorized official

Name

Choonhee Song

Title

Owner

Phone

(646) 919-8951

Specialties & licenses 1

Addresses

Other names 1

• EDEN ADULT DAYCARE Doing business as

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1316664857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 162ND ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583279",
            "telephone_number": "718-353-1004",
            "fax_number": "718-374-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 162ND ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583279",
            "telephone_number": "718-353-1004",
            "fax_number": "718-374-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & K 1004 CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "CHOONHEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-919-8951"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDEN ADULT DAYCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in Flushing, NY
• Providers in Flushing, NY by specialty
• Adult Day Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.