Provider Demographics
NPI:1144595588
Name:LOVE SMILING FACES ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:LOVE SMILING FACES ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-276-3399
Mailing Address - Street 1:9738 LACKLAND RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND
Mailing Address - State:MO
Mailing Address - Zip Code:63114-3424
Mailing Address - Country:US
Mailing Address - Phone:314-276-3399
Mailing Address - Fax:314-291-0797
Practice Address - Street 1:9738 LACKLAND RD
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-3424
Practice Address - Country:US
Practice Address - Phone:314-276-3399
Practice Address - Fax:314-291-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1010251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization