Organization
EVERGREEN ADULT DAY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER SHLAFSHTEYN (MEMBER)
(314) 504-0404
Entity
Organization
Contact information
Practice address
10199 WOODFIELD LN, SAINT LOUIS, MO 63132-2922
(314) 736-1038
(314) 736-1039
Mailing address
10199 WOODFIELD LN, SAINT LOUIS, MO 63132-2922
(314) 736-1038
(314) 736-1039
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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