Healthcare Provider Details

I. General information

NPI: 1104577154
Provider Name (Legal Business Name): A TOUCH OF HOME ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7565 RAVENSRIDGE RD
SAINT LOUIS MO
63119-5502
US

IV. Provider business mailing address

7565 RAVENSRIDGE RD
SAINT LOUIS MO
63119-5502
US

V. Phone/Fax

Practice location:
  • Phone: 314-696-2219
  • 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: SHERNIECE COLEMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-696-2219