Healthcare Provider Details

I. General information

NPI: 1346199239
Provider Name (Legal Business Name): GOOD SHEPHERD ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5990 PAGE BLVD
SAINT LOUIS MO
63112-3500
US

IV. Provider business mailing address

5990 PAGE BLVD
SAINT LOUIS MO
63112-3500
US

V. Phone/Fax

Practice location:
  • Phone: 314-477-5166
  • Fax:
Mailing address:
  • Phone: 314-477-5166
  • 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: MRS. CORTAIGA S COLLINS
Title or Position: DIRECTOR
Credential:
Phone: 314-477-5166