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Organization
ST. ELIZABETH ADULT DAY CARE CENTER INC
Active
Organization
ST. ELIZABETH ADULT DAY CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTONIO MILLER CPPS (ADMINISTRATOR)
(314) 772-5107
Entity
Organization
Contact information
Practice address
1424 S 1ST CAPITOL DR, SAINT CHARLES, MO 63303-3702
(636) 724-2110
(636) 724-2110
Mailing address
3683 COOK AVE, SAINT LOUIS, MO 63113-3831
(314) 772-5107
(314) 772-3674
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1076
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013046937
NPI
MO
01
—
1184740847
NPI
MO
01
—
1407986847
NPI
MO
01
—
1487783254
NPI
MO
01
—
1619006467
NPI
MO
01
—
1730218660
NPI
MO
01
—
1801925664
NPI
MO
Enumeration date
01/17/2013
Last updated
01/17/2013
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