Healthcare Provider Details

I. General information

NPI: 1609216258
Provider Name (Legal Business Name): OPEN ARMS ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10437 SAINT CHARLES ROCK RD
SAINT ANN MO
63074-1815
US

IV. Provider business mailing address

10437 SAINT CHARLES ROCK RD
SAINT ANN MO
63074-1815
US

V. Phone/Fax

Practice location:
  • Phone: 314-427-5700
  • Fax: 314-427-5703
Mailing address:
  • Phone: 314-427-5700
  • Fax: 314-427-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1116
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ZENORA GLOVER
Title or Position: OWNER
Credential:
Phone: 314-397-2788