Healthcare Provider Details

I. General information

NPI: 1609723626
Provider Name (Legal Business Name): SUPERIOR ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W MARGARETTA AVE
SAINT LOUIS MO
63115-2914
US

IV. Provider business mailing address

4200 W MARGARETTA AVE
SAINT LOUIS MO
63115-2914
US

V. Phone/Fax

Practice location:
  • Phone: 314-921-2625
  • Fax: 314-921-2642
Mailing address:
  • Phone: 314-921-2625
  • Fax: 314-921-2642

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: SARA MOSLEY
Title or Position: DIRECTOR
Credential:
Phone: 314-624-5575