Provider Demographics
NPI:1821362682
Name:AFFORDABLE ADULT ASSISTANCE CENTER, LLC
Entity type:Organization
Organization Name:AFFORDABLE ADULT ASSISTANCE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELLISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-363-8883
Mailing Address - Street 1:12662 WILLOW TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-4647
Mailing Address - Country:US
Mailing Address - Phone:314-653-0131
Mailing Address - Fax:314-653-0131
Practice Address - Street 1:12662 WILLOW TRAIL DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-4647
Practice Address - Country:US
Practice Address - Phone:314-653-0131
Practice Address - Fax:314-653-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-26
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care