Buckingham Adult Medical Day Care Center LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

708113 Issued in NJ

Legal business name

BUCKINGHAM ADULT MEDICAL DAY CARE CENTER LLC

Practice address

316 N 6TH St
Prospect Park
Prospect Park, NJ 07508-2122

Phone

(973) 904-3875

Fax

(973) 904-1477

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Cristimina Pearson, BACSW

Title

Administrator

Phone

(973) 907-3875

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477761955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 N 6TH ST",
            "address_2": "PROSPECT PARK",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082122",
            "telephone_number": "973-904-3875",
            "fax_number": "973-904-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N 6TH ST",
            "address_2": "PROSPECT PARK",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082122",
            "telephone_number": "973-904-3875",
            "fax_number": "973-904-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKINGHAM ADULT MEDICAL DAY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "CRISTIMINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "973-907-3875",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BACSW"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NJ",
            "license": "708113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124834",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.