Healthcare Provider Details

I. General information

NPI: 1689519662
Provider Name (Legal Business Name): GOLDEN YEARS ADULT DAYCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FAIRGROUNDS RD STE 105
SAINT CHARLES MO
63301-2381
US

IV. Provider business mailing address

29 GARY CT APT D
SAINT CHARLES MO
63301-2360
US

V. Phone/Fax

Practice location:
  • Phone: 314-546-9485
  • Fax: 636-493-0009
Mailing address:
  • Phone: 314-546-9485
  • Fax: 636-493-0009

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: FELISHA ANN BASS
Title or Position: OWNNER
Credential:
Phone: 314-546-9485