Organization
SUPRA SENIORS 2, LLC
Active
Other names
Yogi Adult Day Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA PAYNE (DIRECTOR)
(314) 696-2510
Entity
Organization
Contact information
Practice address
4365 CHIPPEWA ST, SAINT LOUIS, MO 63116-1606
(314) 696-2510
Mailing address
4365 CHIPPEWA ST, SAINT LOUIS, MO 63116-1606
(314) 696-2510
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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