St Elizabeth Adult Day Care Center
Organization Active NPI Adult Day Care Clinic/Center · Overland, MO
NPI 1619006467 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1619006467
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- License
- 687 (MO)
- Legal business name
- ST ELIZABETH ADULT DAY CARE CENTER
- Practice address
- 2543 Hood Ave
Overland, MO 63114-3259 - Phone
- (314) 890-0005
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
Authorized official
- Name
- John Antonio Miller, C.PP.S. (SISTER)
- Title
- Administrator
- Phone
- (314) 772-5107
Corporate family (same tax ID) 10
National Provider Directory
- Tax ID family
- St Elizabeth Adult Day Care Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 687 | MO | Yes |
Addresses
Primary practice location
2543 Hood Ave
Overland, MO 63114-3259
Mailing address
3401 Arsenal St
Saint Louis, MO 63118-2001
Phone (314) 772-5107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0003472 | Other | MO | SSBG ID |
Other names
- St Elizabeth Adult Day Care Center of Overland
Other providers in Overland, MO
- Rachelle D Smith
- Michael L Spearman
- Specialty Home Healthcare Inc.
- Spirited Living Adult Daycare LLC
- SSM Depaul Medical Group, Inc.
- Star Consumer Directed Services St Louis, LLC
- Alana M. Starr
- State of Missouri
- Colin Swan
- Thomas Joseph Swier
All providers in Overland, MO · Adult Day Care Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.