Healthcare Provider Details

I. General information

NPI: 1437043833
Provider Name (Legal Business Name): SOCIAL GARDEN ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9735 WILDERNESS BATTLE DR
SAINT LOUIS MO
63123-4367
US

IV. Provider business mailing address

9735 WILDERNESS BATTLE DR
SAINT LOUIS MO
63123-4367
US

V. Phone/Fax

Practice location:
  • Phone: 314-800-6190
  • Fax:
Mailing address:
  • Phone: 314-800-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHANNAY M BROWN
Title or Position: OWNER
Credential:
Phone: 314-800-6190