MEDICARE: CINDY'S ADULT DAY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	976	MO

General Provider Information

NPI Number	:	1821370479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINDY'S ADULT DAY CARE LLC

Provider Business Mailing Address
First Line	:	9424 GUTHRIE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-3914
Country	:	US
Telephone Number	:	314-427-9999
Fax Number	:	314-427-9998

Provider Business Practice Location Address
First Line	:	9424 GUTHRIE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-3914
Country	:	US
Telephone Number	:	314-427-9999
Fax Number	:	314-427-9998

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. CYNTHIA GLYNETTE LASTER
Credential	:	LPN
Telephone Number	:	314-427-9999

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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