Organization
GERRI'S ADULT DAY CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANETTA BOLDEN-ROBERTS (BUSINESS MANAGER)
(314) 413-3862
Entity
Organization
Contact information
Practice address
12444 LUSHER RD, SAINT LOUIS, MO 63138-1456
(314) 738-9690
Mailing address
12444 LUSHER RD, SAINT LOUIS, MO 63138-1456
(314) 738-9690
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1215
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215
STATE OF MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES LICENSE
MO
Enumeration date
11/19/2014
Last updated
11/19/2014
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