Healthcare Provider Details

I. General information

NPI: 1770363186
Provider Name (Legal Business Name): ROYAL TOUCH ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WORTHINGTON ACCESS DR # 12-14
MARYLAND HEIGHTS MO
63043-3806
US

IV. Provider business mailing address

1310 HARTING DR
FLORISSANT MO
63031-1970
US

V. Phone/Fax

Practice location:
  • Phone: 314-222-8547
  • Fax: 314-384-8412
Mailing address:
  • Phone: 314-971-8094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: GANEISHA SMITH
Title or Position: OWNER
Credential:
Phone: 314-971-8094