NPI 1770258568

Green Haven Adult Day Program LLC

Organisation Adult Care Home Facility Hazelwood, MO

Practice location

Address: 6207 N Lindbergh Blvd, Hazelwood, MO 63042-2817
Phone: (314) 393-1639
Mailing address: 914 Timberwood Crossing CT, Florissant, MO 63031-7518

Authorised official

Name: Tiffany Danielle Green
Title: Program Director
Phone: (314) 393-1639

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1770258568
Entity type: Organization
NPI issued: 12 Aug 2021
Record last updated: 12 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.