Organization
HOUSE OF DESTINY ADULT DAY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE TERRY (EXECUTIVE DIRECTOR)
(314) 669-1755
Entity
Organization
Contact information
Practice address
4507 OLIVE STREET, ST LOUIS, MO 63108
(314) 669-1755
Mailing address
4507 OLIVE ST, SAINT LOUIS, MO 63108-1814
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1428
MO
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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