Healthcare Provider Details

I. General information

NPI: 1134720097
Provider Name (Legal Business Name): HAND TO HAND ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2543 HOOD AVE
OVERLAND MO
63114-3259
US

IV. Provider business mailing address

2543 HOOD AVE
OVERLAND MO
63114-3259
US

V. Phone/Fax

Practice location:
  • Phone: 314-736-1093
  • Fax: 314-736-1097
Mailing address:
  • Phone: 314-736-1093
  • Fax: 314-736-1097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENDRA KARMEL FITZGERALD
Title or Position: OWNER
Credential:
Phone: 314-677-7908