NPIMap

Organization Active NPI

Evergreen Adult Day Care in Ny, Inc

  • Adult Day Care Clinic/Center
  • Flushing, NY
National Provider Identifier
1851641500
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
EVERGREEN ADULT DAY CARE IN NY, INC
Practice address
144-74 Northern Blvd
2 FL.
Flushing, NY 11354
Phone
(718) 321-2112
Fax
(718) 925-4105
NPI assigned
Sep 10, 2012
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Ms. Hyun Jong Icoo
Title
President
Phone
(718) 321-2112

Specialties & licenses 1

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

Addresses

Primary practice location

144-74 Northern Blvd
2 FL.
Flushing, NY 11354

Mailing address

144-74 Northern Blvd
2 FL.
Flushing, NY 11354
Phone (718) 321-2112

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Adult Day Care in New York CN3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3710 149th Pl
Ste 1A
Flushing, NY 11354
Phone (718) 358-3355

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1851641500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144-74 NORTHERN BLVD",
            "address_2": "2 FL.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-321-2112",
            "fax_number": "718-925-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144-74 NORTHERN BLVD",
            "address_2": "2 FL.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-321-2112",
            "fax_number": "718-925-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ADULT DAY CARE IN NY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "ICOO",
        "authorized_official_first_name": "HYUN JONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-321-2112",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.