Provider Demographics
NPI:1235413295
Name:GREATER LOVE ADULT DAYCARE, LLC
Entity Type:Organization
Organization Name:GREATER LOVE ADULT DAYCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-920-5130
Mailing Address - Street 1:8081 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2022
Mailing Address - Country:US
Mailing Address - Phone:314-997-4776
Mailing Address - Fax:314-997-4779
Practice Address - Street 1:8081 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-2022
Practice Address - Country:US
Practice Address - Phone:314-997-4776
Practice Address - Fax:314-997-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO979261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care