Provider Demographics
NPI:1811745151
Name:ELITE ADULT DAY CARE LLC
Entity type:Organization
Organization Name:ELITE ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-488-5240
Mailing Address - Street 1:7289 NATURAL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORMANDY
Mailing Address - State:MO
Mailing Address - Zip Code:63121-5045
Mailing Address - Country:US
Mailing Address - Phone:314-488-5240
Mailing Address - Fax:
Practice Address - Street 1:7320 FLORISSANT RD
Practice Address - Street 2:
Practice Address - City:NORMANDY
Practice Address - State:MO
Practice Address - Zip Code:63121-2526
Practice Address - Country:US
Practice Address - Phone:314-405-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care