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General NPI Number Information
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NPI Number | 1710810825
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Entity Type | Organization
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Legal Business Name | TIA'S ADULT DAYCARE LLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 212 E ELM ST
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City | ALTON
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State | IL
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Zip | 62002-5201
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Country | US
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Telephone | 314-441-1923
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Fax |
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Provider Business Mailing Address
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Address Line | 14623 ROUVRE DR
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City | FLORISSANT
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State | MO
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Zip | 63034-2317
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Country | US
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Telephone | 314-441-1923
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TILWUANA WELLS
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Credential | PLBA
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Telephone | 314-441-1923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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