Provider Demographics
NPI:1558346767
Name:SENIORS & COMPANY ADULT DAY SERVICES
Entity Type:Organization
Organization Name:SENIORS & COMPANY ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-926-2121
Mailing Address - Street 1:115 PIPER HILL DR
Mailing Address - Street 2:
Mailing Address - City:ST PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1620
Mailing Address - Country:US
Mailing Address - Phone:636-926-2121
Mailing Address - Fax:636-926-2071
Practice Address - Street 1:115 PIPER HILL DR
Practice Address - Street 2:
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1620
Practice Address - Country:US
Practice Address - Phone:636-926-2121
Practice Address - Fax:636-926-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO402261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0004524OtherSSBG