Provider Demographics
NPI:1265804256
Name:CAMBRIDGE ADULT DAY CENTER-DEXTER
Entity type:Organization
Organization Name:CAMBRIDGE ADULT DAY CENTER-DEXTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GYURCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-614-5788
Mailing Address - Street 1:812 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-1021
Mailing Address - Country:US
Mailing Address - Phone:573-614-5788
Mailing Address - Fax:573-614-5782
Practice Address - Street 1:812 W OAK ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MO
Practice Address - Zip Code:63841-1021
Practice Address - Country:US
Practice Address - Phone:573-614-5788
Practice Address - Fax:573-614-5782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1280261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care