MEDICARE: SALPE ADULT DAYCARE CENTER

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	:	1952118861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALPE ADULT DAYCARE CENTER

Provider Business Mailing Address
First Line	:	1661 HWY. 65
Second Line	:
City	:	LAKE VILLAGE
State	:	AR
Zip	:	71653
Country	:	US
Telephone Number	:	870-632-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1661 HWY. 65
Second Line	:
City	:	LAKE VILLAGE
State	:	AR
Zip	:	71653
Country	:	US
Telephone Number	:	870-632-5055
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. EDDIE ADAMS
Credential	:
Telephone Number	:	662-390-7249

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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