Healthcare Provider Details

I. General information

NPI: 1174654297
Provider Name (Legal Business Name): RIVERVIEW ADULT DAYCARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 12/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8941 RIVERVIEW DR RIVERVIEW PLAZA
SAINT LOUIS MO
63137-2404
US

IV. Provider business mailing address

8941 RIVERVIEW DR RIVERVIEW PLAZA
SAINT LOUIS MO
63137-2404
US

V. Phone/Fax

Practice location:
  • Phone: 314-868-3030
  • Fax: 314-868-3043
Mailing address:
  • Phone: 314-868-3030
  • Fax: 314-868-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number663
License Number StateMO

VIII. Authorized Official

Name: MRS. MARTHA NASH
Title or Position: PRESIDENT
Credential:
Phone: 314-868-3030