Organization Name: | CAMBRIDGE ADULT DAY CENTER WALTON LLC |
NPI Number: | 1225446610 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD G BRIGGS (MANAGING MEMBER) |
Mailing Address: | 2075 Walton Rd Overland |
State: | MO US |
Postal Code: | 631145805 |
Phone Number: | 3145048529 |
Fax Number: | 3144807297 |
NPI Enumeration Date: | 07/29/2014 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | 1267 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |