Healthcare Provider Details

I. General information

NPI: 1124866314
Provider Name (Legal Business Name): HUMBLED HANDZ ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 PORTWEST CT
SAINT CHARLES MO
63303-5985
US

IV. Provider business mailing address

32 PORTWEST CT
SAINT CHARLES MO
63303-5985
US

V. Phone/Fax

Practice location:
  • Phone: 314-280-6366
  • Fax:
Mailing address:
  • Phone: 314-280-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TANIKA ESTERS
Title or Position: REGISTERED NUSE
Credential: RN,BSN
Phone: 314-724-4354