Provider Demographics
NPI:1164271839
Name:ANGELS TOUCH ADULT DAY CENTER LC
Entity type:Organization
Organization Name:ANGELS TOUCH ADULT DAY CENTER LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-361-5800
Mailing Address - Street 1:2609 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63106-3914
Mailing Address - Country:US
Mailing Address - Phone:314-361-5800
Mailing Address - Fax:314-361-5800
Practice Address - Street 1:2628 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1404
Practice Address - Country:US
Practice Address - Phone:314-361-5800
Practice Address - Fax:314-361-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care