Healthcare Provider Details

I. General information

NPI: 1558346767
Provider Name (Legal Business Name): SENIORS & COMPANY ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PIPER HILL DR
ST PETERS MO
63376-1620
US

IV. Provider business mailing address

115 PIPER HILL DR
ST PETERS MO
63376-1620
US

V. Phone/Fax

Practice location:
  • Phone: 636-926-2121
  • Fax: 636-926-2071
Mailing address:
  • Phone: 636-926-2121
  • Fax: 636-926-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number402
License Number StateMO

VIII. Authorized Official

Name: LAURA SULLIVAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 636-926-2121