Provider Demographics
NPI:1720503642
Name:LOVE AND LAUGHTER ADULT DAY CARE
Entity Type:Organization
Organization Name:LOVE AND LAUGHTER ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-296-0344
Mailing Address - Street 1:10134 BARON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5510
Mailing Address - Country:US
Mailing Address - Phone:314-296-0344
Mailing Address - Fax:
Practice Address - Street 1:10134 BARON DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5510
Practice Address - Country:US
Practice Address - Phone:314-296-0344
Practice Address - Fax:314-296-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)