Provider Demographics
NPI:1679390330
Name:FRIENDS FOR LIFE ADULT DAY CARE LLC
Entity type:Organization
Organization Name:FRIENDS FOR LIFE ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONESHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-600-8105
Mailing Address - Street 1:232 MAYFAIR PLAZA SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-8009
Mailing Address - Country:US
Mailing Address - Phone:314-685-9672
Mailing Address - Fax:314-801-8437
Practice Address - Street 1:232 MAYFAIR PLAZA SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-8009
Practice Address - Country:US
Practice Address - Phone:314-685-9672
Practice Address - Fax:314-801-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care