Provider Demographics
NPI:1407022007
Name:CARING HEART ADULT SERVICES CENTER LLC
Entity Type:Organization
Organization Name:CARING HEART ADULT SERVICES CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-428-4020
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:314-428-4020
Mailing Address - Fax:314-695-5113
Practice Address - Street 1:9525 LACKLAND RD
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-3602
Practice Address - Country:US
Practice Address - Phone:314-428-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-03
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO296247307Medicaid