Home Away From Home Adult Daycare
Custodial Care Facility, Adult Care Home in Saint Louis, MO. Organization (NPI-2).
NPI number1104036003
StatusActive
Last updated in NPPESMay 29, 2008
Details
- NPI
- 1104036003
- Entity type
- Organization (NPI-2)
- Legal business name
- Home Away From Home Adult Daycare
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- May 29, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
Practice location
5535 Delmar BlvdSaint Louis, MO 63112-3005
Phone 314-265-2096
Mailing address
Po Box 32086Olivette, MO 63132-8086
Authorized official
Andrea Jones
Owner
3147138222
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