Healthcare Provider Details

I. General information

NPI: 1831576990
Provider Name (Legal Business Name): ARBOR HEALTH ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 04/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 PENNSYLVANIA AVE
UNIVERSITY CITY MO
63130-2325
US

IV. Provider business mailing address

6960 OLIVE STREET
UNIVERSITY CITY MO
63130
US

V. Phone/Fax

Practice location:
  • Phone: 314-726-1100
  • Fax:
Mailing address:
  • Phone: 314-726-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WES P SPERR
Title or Position: MEMBER
Credential: MBA
Phone: 636-489-8118