Provider Demographics
NPI:1841539970
Name:ANOINTED SEASONED ADULTS
Entity type:Organization
Organization Name:ANOINTED SEASONED ADULTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:I
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-524-9004
Mailing Address - Street 1:15666 DEBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3481
Mailing Address - Country:US
Mailing Address - Phone:314-524-9004
Mailing Address - Fax:314-524-4271
Practice Address - Street 1:8368 LATTY AVE
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-3236
Practice Address - Country:US
Practice Address - Phone:314-524-9004
Practice Address - Fax:314-524-4271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1091302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization