Jezliah Adult Social Daycare

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

400Q268 Issued in NY

Legal business name

JEZLIAH ADULT SOCIAL DAYCARE

Practice address

501 Jefferson Ave
Rockville Centre, NY 11570-3311

Phone

(516) 678-0728

Fax

(516) 678-0728

NPI assigned

Mar 18, 2013

Organization subpart

Yes

Parent organization

JEZLIAH FAMILY TYPE HOME FOR ADULTSAs reported in NPPES

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

Authorized official

Name

Faith C Hutchinson

Title

Owner

Phone

(516) 678-0728

Specialties & licenses 1

Addresses

Part of

Jezliah Adult Social Daycare

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363564800000",
    "number": "1609118694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 JEFFERSON AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703311",
            "telephone_number": "516-678-0728",
            "fax_number": "516-678-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 JEFFERSON AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703311",
            "telephone_number": "516-678-0728",
            "fax_number": "516-678-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEZLIAH ADULT SOCIAL DAYCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEZLIAH FAMILY TYPE HOME FOR ADULTS",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A",
        "authorized_official_last_name": "HUTCHINSON",
        "authorized_official_first_name": "FAITH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-678-0728"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NY",
            "license": "400Q268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.