NPIMap

Organization Active NPI

St. Elizabeth Adult Day Care Center, Inc.

  • Adult Day Care Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1205965118
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
647 Issued in MO
Legal business name
ST. ELIZABETH ADULT DAY CARE CENTER, INC.
Practice address
3227 S 9TH St
Saint Louis, MO 63118-2629
Phone
(314) 771-1591
NPI assigned
Mar 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Antonio Miller, C.PP.S.
Title
Administrator
Phone
(314) 772-5107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 647 MO Primary

Addresses

Primary practice location

3227 S 9TH St
Saint Louis, MO 63118-2629

Mailing address

3401 Arsenal St
Saint Louis, MO 63118-2001
Phone (314) 772-5107

Other identifiers 1

IdentifierTypeStateIssuer
0001643OtherMOSSBG ID

Other names 1

  • St Elizabeth East Adult Day Care Center Other name

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeth Adult Day Care Center Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3227 S 9th St
Saint Louis, MO 63118
Phone (314) 771-1591

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205965118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 ARSENAL ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631182001",
            "telephone_number": "314-772-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 S 9TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631182629",
            "telephone_number": "314-771-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ELIZABETH ADULT DAY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-772-5107",
        "authorized_official_credential": "C.PP.S."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MO",
            "license": "647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSBG ID",
            "identifier": "0001643",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth East Adult Day Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.