Organization
ST. ELIZABETH ADULT DAY CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTONIO MILLER CPPS (ADMINISTRATOR)
(314) 772-5107
Entity
Organization
Contact information
Practice address
1424 S 1ST CAPITOL DR, SAINT CHARLES, MO 63303-3702
(636) 724-2110
(636) 724-2110
Mailing address
3683 COOK AVE, SAINT LOUIS, MO 63113-3831
(314) 772-5107
(314) 772-3674
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1076
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013046937
NPI
MO
01
—
1184740847
NPI
MO
01
—
1407986847
NPI
MO
01
—
1487783254
NPI
MO
01
—
1619006467
NPI
MO
01
—
1730218660
NPI
MO
01
—
1801925664
NPI
MO
Enumeration date
01/17/2013
Last updated
01/17/2013
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