Healthcare Provider Details

I. General information

NPI: 1104618693
Provider Name (Legal Business Name): A SILVER LINING ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3748 DELOR ST
SAINT LOUIS MO
63116-4154
US

IV. Provider business mailing address

411 SPRUCE DR
FESTUS MO
63028-1533
US

V. Phone/Fax

Practice location:
  • Phone: 256-348-1497
  • Fax:
Mailing address:
  • Phone: 256-348-1497
  • 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: DAVID T RUSSELL
Title or Position: MANAGING OFFICER
Credential:
Phone: 256-348-1497