Organization
ENHANCED QUALITY OF LIFE LLC ADULT DAY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMONE WEBB (OWNER)
(314) 839-7790
Entity
Organization
Contact information
Practice address
400 CHEZ PAREE DR, HAZELWOOD, MO 63042-3540
(314) 839-7790
Mailing address
PO BOX 262, FLORISSANT, MO 63032-0262
(314) 839-7790
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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