Healthcare Provider Details

I. General information

NPI: 1255229704
Provider Name (Legal Business Name): GRACEFUL HANDS ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 S FLORISSANT RD
SAINT LOUIS MO
63135-2333
US

IV. Provider business mailing address

4037 KOELN AVE
SAINT LOUIS MO
63116-2727
US

V. Phone/Fax

Practice location:
  • Phone: 314-706-5489
  • Fax: 314-706-5489
Mailing address:
  • Phone: 314-706-5489
  • 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: KEISHA GILBERT
Title or Position: DIRECTOR
Credential: BSN,RN
Phone: 314-706-5489