Organization
COUNTRY LIVING ADULT DAY CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANETTE HAMILTON (DIRECTOR OF NURSING)
(314) 361-7778
Entity
Organization
Contact information
Practice address
5622 DELMAR BLVD, SUITE102, SAINT LOUIS, MO 63112-2600
(314) 361-7778
(314) 361-7776
Mailing address
5622 DELMAR BLVD, SUITE102, SAINT LOUIS, MO 63112-2600
(314) 361-7778
(314) 361-7776
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518189141
—
MO
Enumeration date
05/06/2008
Last updated
05/06/2008
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