Healthcare Provider Details
I. General information
NPI: 1104573856
Provider Name (Legal Business Name): SAIGON ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2022
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6589 N OAK TRFY
GLADSTONE MO
64118-3330
US
IV. Provider business mailing address
6589 N OAK TRFY
GLADSTONE MO
64118-3330
US
V. Phone/Fax
- Phone: 816-577-2212
- Fax:
- Phone: 619-616-1154
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CUONG
Q
NGUYEN
Title or Position: PRESIDENT
Credential:
Phone: 619-616-1154