Supra Seniors 2, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SUPRA SENIORS 2, LLC

Doing business as

Yogi Adult Day Care

Practice address

4365 Chippewa St
Saint Louis, MO 63116-1606

Phone

(314) 696-2510

NPI assigned

Dec 10, 2015

Last updated

Dec 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Alicia Payne

Title

Director

Phone

(314) 696-2510

Specialties & licenses 1

Addresses

Other names 1

• Yogi Adult Day Care Doing business as

Locations

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1720453178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4365 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161606",
            "telephone_number": "314-696-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161606",
            "telephone_number": "314-696-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPRA SENIORS 2, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-696-2510",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yogi Adult Day Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.