Healthcare Provider Details

I. General information

NPI: 1396455424
Provider Name (Legal Business Name): BEST LOVE & CARE ADULT DAY CLUB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 UNION BLVD
SAINT LOUIS MO
63115-1119
US

IV. Provider business mailing address

6156 LAKE PADDOCK DR
FLORISSANT MO
63033-4721
US

V. Phone/Fax

Practice location:
  • Phone: 636-220-1395
  • Fax: 636-220-1396
Mailing address:
  • Phone: 314-604-2285
  • 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: KLONDA KING
Title or Position: DIRECTOR
Credential:
Phone: 314-604-2285