Provider Demographics
NPI:1558652172
Name:WINDHAM ENTERPRISES, LLC
Entity Type:Organization
Organization Name:WINDHAM ENTERPRISES, LLC
Other - Org Name:LIVING BETTER ADULT DAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WINDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-839-9199
Mailing Address - Street 1:2032 DORSETT VLG
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2208
Mailing Address - Country:US
Mailing Address - Phone:314-542-6050
Mailing Address - Fax:314-542-6026
Practice Address - Street 1:2032 DORSETT VLG
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2208
Practice Address - Country:US
Practice Address - Phone:314-542-6050
Practice Address - Fax:314-542-6026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDHAM ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO936261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care