Organization
ST ELIZABETH ADULT DAY CARE CENTER
Active
Other names
St Elizabeth Adult Day Care Center of Overland
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTONIO MILLER C.PP.S. (SISTER) (ADMINISTRATOR)
(314) 772-5107
Entity
Organization
Contact information
Practice address
2543 HOOD AVE, OVERLAND, MO 63114-3259
(314) 890-0005
Mailing address
3401 ARSENAL ST, SAINT LOUIS, MO 63118-2001
(314) 772-5107
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
687
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003472
SSBG ID
MO
Enumeration date
03/05/2007
Last updated
08/22/2020
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