Healthcare Provider Details

I. General information

NPI: 1346695582
Provider Name (Legal Business Name): MCCLAY ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 MCCLAY RD
SAINT PETERS MO
63376-7327
US

IV. Provider business mailing address

3821 MCCLAY RD
SAINT PETERS MO
63376-7327
US

V. Phone/Fax

Practice location:
  • Phone: 636-922-9595
  • Fax:
Mailing address:
  • Phone: 636-922-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1323
License Number StateMO

VIII. Authorized Official

Name: MRS. JENNIFER GETTMAN
Title or Position: CEO OWNER
Credential: MA, CEO, NHA
Phone: 636-219-3114