Organization
SUPRA SENIORS LLC
Active
Other names
Sarah Care Centre Adult Day Services
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIS LANE ALLEN (EXECUTIVE DIRECTOR)
(314) 968-2222
Entity
Organization
Contact information
Practice address
524 S ELM AVE, WEBSTER GROVES, MO 63119
(314) 968-2222
(314) 968-2224
Mailing address
524 S ELM AVE, WEBSTER GROVES, MO 63119
(314) 968-2222
(314) 968-2224
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
685
MO
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296305709
—
MO
05
—
685
—
MO
Enumeration date
06/11/2007
Last updated
07/25/2008
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