Organization
UNDER GRACE ADULT DAY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHAUNA PARKER (DIRECTOR)
(314) 391-9415
Entity
Organization
Contact information
Practice address
4202 BONFILS DR, BRIDGETON, MO 63044-1903
(314) 391-9415
(314) 254-7349
Mailing address
9191 W FLORISSANT AVE STE 200B, SAINT LOUIS, MO 63136-1413
(314) 391-9415
(314) 254-7349
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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