NPIMap

Organization Active NPI

Northeast Adult Day Care Inc

  • Adult Day Care Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1780752535
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
313010 Issued in PA
Legal business name
NORTHEAST ADULT DAY CARE INC
Practice address
11048 Rennard St
Philadelphia, PA 19116-2618
Phone
(215) 671-0200
Fax
(215) 671-0686
NPI assigned
Dec 1, 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
Vlada Rubarkh, R.N.
Title
President
Phone
(215) 671-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 313010 PA Primary

Addresses

Primary practice location

11048 Rennard St
Philadelphia, PA 19116-2618

Mailing address

11048 Rennard St
Philadelphia, PA 19116-2618
Phone (215) 671-0200

Other identifiers 1

IdentifierTypeStateIssuer
1007686610004MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Northeast Adult Day Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780752535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11048 RENNARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162618",
            "telephone_number": "215-671-0200",
            "fax_number": "215-671-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11048 RENNARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162618",
            "telephone_number": "215-671-0200",
            "fax_number": "215-671-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ADULT DAY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUBARKH",
        "authorized_official_first_name": "VLADA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-671-0200",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "313010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007686610004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

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.