Healthcare Provider Details

I. General information

NPI: 1073051371
Provider Name (Legal Business Name): RUTH & NAOMI ADULT DAY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9443-9445 LACKLAND ROAD
ST. LOUIS MO
63114
US

IV. Provider business mailing address

PO BOX 140054
SAINT LOUIS MO
63114-0054
US

V. Phone/Fax

Practice location:
  • Phone: 314-575-8775
  • Fax:
Mailing address:
  • Phone: 314-575-8775
  • 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: MRS. TAMARA SCAIFE
Title or Position: OWNER
Credential: ANP-C
Phone: 314-575-8775