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General NPI Number Information
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NPI Number | 1437517414
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Entity Type | Organization
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Legal Business Name | ALL GENERATIONS ADULT DAY CENTER,LLC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 2061 EXCHANGE DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-5987
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Country | US
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Telephone | 636-410-8303
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Fax | 636-410-7707
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Provider Business Mailing Address
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Address Line | 2061 EXCHANGE DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-5987
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Country | US
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Telephone | 636-410-8303
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Fax | 636-410-7707
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. TIFFANY RENEE MAYS
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Credential | B.S.
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Telephone | 636-410-8303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | MO
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