Organization
CELEBRATION CITY COMMUNITY CENTER
Active
Parent organization
SAME AS ABOVE
Other names
same as above, Celebration City Community Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAME AS ABOVE
Authorized official
MR. PRIENTISS THOMAS BS THEOLOGY, D. DIVI (PROGRAM DIRECTOR)
(314) 761-6132
Entity
Organization
Contact information
Practice address
4130 E LEXINGTON AVE, SAINT LOUIS, MO 63115-3333
(314) 261-4348
(313) 449-1338
Mailing address
1703 STONEY TERRACE DR, BALLWIN, MO 63021-7783
(314) 761-6132
(314) 449-1338
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29
—
MO
Enumeration date
11/25/2019
Last updated
11/25/2019
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