Provider Demographics
NPI:1801284963
Name:ONE FOR ALL DAY PROGRAM LLC
Entity type:Organization
Organization Name:ONE FOR ALL DAY PROGRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:LOEPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-635-4501
Mailing Address - Street 1:3620 W TRUMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-6125
Mailing Address - Country:US
Mailing Address - Phone:573-635-4501
Mailing Address - Fax:
Practice Address - Street 1:3620 W TRUMAN BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6125
Practice Address - Country:US
Practice Address - Phone:573-635-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-24
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO29407261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care