Healthcare Provider Details

I. General information

NPI: 1992906937
Provider Name (Legal Business Name): ADULTCARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12444 LUSHER RD
SAINT LOUIS MO
63138-1456
US

IV. Provider business mailing address

12444 LUSHER RD
SAINT LOUIS MO
63138-1456
US

V. Phone/Fax

Practice location:
  • Phone: 314-741-3535
  • Fax: 314-741-3599
Mailing address:
  • Phone: 314-741-3535
  • Fax: 314-741-3599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number702
License Number StateMO

VIII. Authorized Official

Name: MR. ARTHUR JORDAN
Title or Position: CEO & PROGRAMDIRECTOR
Credential:
Phone: 314-741-3535