Healing Waters Adult Daycare

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

HEALING WATERS ADULT DAYCARE

Practice address

1777 N New Florissant Rd
Florissant, MO 63033-1905

Phone

(131) 439-7619

NPI assigned

Feb 10, 2023

Organization subpart

No

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

Authorized official

Name

Adrienne Harris

Title

Owner

Phone

(314) 397-6197

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HEALING WATERS OF ST LOUIS LLC Other name

Locations

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1861199770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N NEW FLORISSANT RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331905",
            "telephone_number": "314-397-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N NEW FLORISSANT RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331905",
            "telephone_number": "131-439-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING WATERS ADULT DAYCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-397-6197"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "908282",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALING WATERS OF ST LOUIS LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Day Care Clinic/Center in Florissant, MO
• Providers in Florissant, 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 Feb 10, 2023; 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.