Provider Demographics
NPI:1578878732
Name:NORTH COUNTY ADULT CENTER LLC
Entity Type:Organization
Organization Name:NORTH COUNTY ADULT CENTER LLC
Other - Org Name:NCAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-972-8200
Mailing Address - Street 1:4205 SHERMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4500
Mailing Address - Country:US
Mailing Address - Phone:314-972-8200
Mailing Address - Fax:314-972-8964
Practice Address - Street 1:500 GREENWAY MANOR DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031
Practice Address - Country:US
Practice Address - Phone:314-972-8200
Practice Address - Fax:314-972-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle