# ST. ELIZABETH ADULT DAY CARE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871831339
- **Authorized official:** JOHN ANTONIO MILLER CPPS (ADMINISTRATOR)
- **Authorized official phone:** (314) 772-5107

## Contact information

- **Practice address:** 1424 S 1ST CAPITOL DR, SAINT CHARLES, MO 63303-3702
- **Practice address phone:** (636) 724-2110
- **Practice address fax:** (636) 724-2110
- **Mailing address:** 3683 COOK AVE, SAINT LOUIS, MO 63113-3831
- **Mailing address phone:** (314) 772-5107
- **Mailing address fax:** (314) 772-3674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 1076 | MO | Yes |

## Other

- **Enumeration date:** 01/17/2013
- **Last updated:** 01/17/2013

## 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 |