Provider Demographics
NPI:1952777005
Name:MAJESTIC ADULT CARE CENTER
Entity Type:Organization
Organization Name:MAJESTIC ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BONICA
Authorized Official - Middle Name:CORINE
Authorized Official - Last Name:STROTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-831-6300
Mailing Address - Street 1:508 GREENWAY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-1398
Mailing Address - Country:US
Mailing Address - Phone:314-831-6300
Mailing Address - Fax:314-831-6303
Practice Address - Street 1:508 GREENWAY CHASE DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1398
Practice Address - Country:US
Practice Address - Phone:314-831-6300
Practice Address - Fax:314-831-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care