Organization Active NPI

Soc Care Center, LLC

  • Adult Day Care Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1396309597
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
SOC CARE CENTER, LLC
Practice address
4029 Gravois Ave
Saint Louis, MO 63116-3622
Phone
(314) 696-2396
Fax
(314) 696-2426
NPI assigned
Apr 24, 2019
Last updated
Apr 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Authorized official

Name
Mary Johnson
Title
Director
Phone
(314) 696-2396

Specialties & licenses 1

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

Addresses

Primary practice location

4029 Gravois Ave
Saint Louis, MO 63116-3622

Mailing address

4029 Gravois Ave
Saint Louis, MO 63116-3622
Phone (314) 696-2396

National Provider Directory

National Provider Directory

Locations

4029 Gravois Ave
Saint Louis, MO 63116
Phone (314) 696-2396

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1396309597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 GRAVOIS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163622",
            "telephone_number": "314-696-2396",
            "fax_number": "314-696-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 GRAVOIS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163622",
            "telephone_number": "314-696-2396",
            "fax_number": "314-696-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOC CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-696-2396"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 24, 2019; 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.