Provider Demographics
NPI:1801608815
Name:JANAES ADULT DAY CLUB
Entity type:Organization
Organization Name:JANAES ADULT DAY CLUB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-249-8378
Mailing Address - Street 1:2109 WILLOW TRACE DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-5203
Mailing Address - Country:US
Mailing Address - Phone:314-249-8378
Mailing Address - Fax:
Practice Address - Street 1:2109 WILLOW TRACE DR
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-5203
Practice Address - Country:US
Practice Address - Phone:314-249-8378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care