NPI:
1295071074
Provider Name:
EDEN ADULT MEDICAL DAYCARE CENTER, INC.
Doing Business As: ST.JOHN ADULT MEDICAL DAYCARE, INC.
Classification:
Clinic/Center - 261QA0600X
Entity Type:
Organization
Specialization: Adult Day Care
CLIA Number: 21D2008733
Address:
10947 GOLDEN WEST DR STE 200
HUNT VALLEY, MD
ZIP 21031
Phone:
(410) 329-1444
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EDEN ADULT MEDICAL DAYCARE CENTER, INC. is an adult day care clinic center in Hunt Valley, MD. EDEN ADULT MEDICAL DAYCARE CENTER, INC. NPI is 1295071074. The provider is registered as an organization entity type.
The provider Is Doing Business As St.john Adult Medical Daycare, Inc..
The provider's business location address is:
10947 GOLDEN WEST DR STE 200
HUNT VALLEY, MD
ZIP 21031-341
Phone: (410) 329-1444
Fax: (410) 329-1533
The provider's authorized official is Amy Shinsoon Lee .
The authorized official title is Owner and has the following contact phone number (410) 329-1444.
The CLIA number assigned to this NPI record is 21D2008733 - other - medical adult daycare with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/22/2012 and was last updated on 12/22/2012.