Provider Demographics
NPI:1437517414
Name:ALL GENERATIONS ADULT DAY CENTER,LLC
Entity Type:Organization
Organization Name:ALL GENERATIONS ADULT DAY CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:636-410-8303
Mailing Address - Street 1:2061 EXCHANGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5987
Mailing Address - Country:US
Mailing Address - Phone:636-410-8303
Mailing Address - Fax:636-410-7707
Practice Address - Street 1:2061 EXCHANGE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5987
Practice Address - Country:US
Practice Address - Phone:636-410-8303
Practice Address - Fax:636-410-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care