Healthcare Provider Details

I. General information

NPI: 1487512992
Provider Name (Legal Business Name): OPULENT CARE ADULT DAYCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 N MAIN ST
SIKESTON MO
63801-2170
US

IV. Provider business mailing address

335 N MAIN ST
SIKESTON MO
63801-2170
US

V. Phone/Fax

Practice location:
  • Phone: 573-607-0632
  • Fax:
Mailing address:
  • Phone: 573-607-0632
  • Fax:

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: TIFFANY HARRIS
Title or Position: OWNER
Credential:
Phone: 573-607-0632