MEDICARE: PASSION ADULT DAYCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1194456749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSION ADULT DAYCARE LLC

Provider Business Mailing Address
First Line	:	4068 MAFFITT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-3235
Country	:	US
Telephone Number	:	314-933-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	4068 MAFFITT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-3235
Country	:	US
Telephone Number	:	314-933-0155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LANISHA MARTIN
Credential	:
Telephone Number	:	314-933-0155

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	06/23/2022

Similar Medicare Providers

1275475279 — GOD GIVEN HEART LLC
Practice Location Address:

4064 MAFFITT AVE
SAINT LOUIS, MO
63113-3235

Practice Phone: 314-933-0155
Practice Fax:

1477291839 — LANISHA MARTIN COTA/L
Practice Location Address:

4068 MAFFITT AVE
SAINT LOUIS, MO
63113-3235

Practice Phone: 314-933-0155
Practice Fax:

1497585301 — UNFAILING LOVE CRC (COMMUNITY RESOURCE CENTER)
Practice Location Address:

4068 MAFFITT AVE
SAINT LOUIS, MO
63113-3235

Practice Phone: 314-226-9705
Practice Fax:

1487276127 — MIRANDA PITONAK MA, LPC, CRC
Practice Location Address:

659 BEATRICE AVE
SAINT LOUIS, MO
63125-3235

Practice Phone: 314-740-8449
Practice Fax:

1508154816 — SHELBYVILLE CENTRAL SCHOOLS
Practice Location Address:

803 SAINT JOSEPH ST
SHELBYVILLE, IN
46176-3235

Practice Phone: 317-392-2505
Practice Fax:

1003213653 — YELINA KIM CCC-SLP
Practice Location Address:

234 SAINT MARYS ST
PHOENIXVILLE, PA
19460-3235

Practice Phone: 724-674-5038
Practice Fax:

Directions to “PASSION ADULT DAYCARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.