| Organization Name: | ST ELIZABETH ADULT DAY CARE CENTER |
| NPI Number: | 1619006467 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN ANTONIO MILLER (ADMINISTRATOR) |
| Mailing Address: | 2543 Hood Ave Overland |
| State: | MO US |
| Postal Code: | 631143259 |
| Phone Number: | 3148900005 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 687 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |