Healthcare Provider Details

I. General information

NPI: 1952209355
Provider Name (Legal Business Name): W.F.S. ADULT DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2026
Last Update Date: 10/27/2026
Certification Date: 10/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6111 BLUE RIDGE BLVD
RAYTOWN MO
64133-4105
US

IV. Provider business mailing address

6111 BLUE RIDGE BLVD # 64130
RAYTOWN MO
64133-4105
US

V. Phone/Fax

Practice location:
  • Phone: 314-713-1105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: BRITTANY WALLACE
Title or Position: OWNER
Credential:
Phone: 314-713-1105