Healthcare Provider Details

I. General information

NPI: 1861845166
Provider Name (Legal Business Name): BEGINNING ANEW ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 S VANDEVENTER AVE
SAINT LOUIS MO
63110-2336
US

IV. Provider business mailing address

1470 S VANDEVENTER AVE
SAINT LOUIS MO
63110-2336
US

V. Phone/Fax

Practice location:
  • Phone: 314-993-5580
  • Fax: 314-991-7745
Mailing address:
  • Phone: 314-993-5580
  • Fax: 314-991-7745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMO

VIII. Authorized Official

Name: GLENDA FAYE WHITE
Title or Position: CEO
Credential: BSN, MBA
Phone: 314-993-5580