CELEBRATION CITY COMMUNITY CENTER (NPI# 1346886488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346886488 |
| Entity Type | Organization |
| Organization Name | CELEBRATION CITY COMMUNITY CENTER |
| Practice Address |
4130 E Lexington Ave Saint Louis MO 63115-3333 |
| Mailing Address |
1703 Stoney Terrace Dr Ballwin MO 63021-7783 |
| Practice Telephone | 3142614348 |
| Practice Fax Number | 3134491338 |
| Mailing Telephone | 3147616132 |
| Mailing Fax Number | 3144491338 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | MR. PRIENTISS THOMAS (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 3147616132 |
| Authorized Official Credential | BS THEOLOGY, D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SAME AS ABOVE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 29 | 05 |
| Other Name | Type Code |
|---|---|
| Celebration City Community Center | Doing Business As Name - Organization |
| same as above | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4126-4130 East Lexington Avenue, St. Louis, MO 63115 | 3142614348 | 3144491338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858202 | Celebration City Community Center | Home Health | 4130 E Lexington Ave, Saint Louis, MO 63115-3333 | 2019-12-18 |
| Street Address |
4130 E LEXINGTON AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63115-3333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225377401 | The State of The Art Adult Healthcare Centre | Clinic/Center | 4130 E Lexington Ave, Saint Louis, MO 63115-3333 | 2013-02-07 |
| 1043858202 | Celebration City Community Center | Home Health | 4130 E Lexington Ave, Saint Louis, MO 63115-3333 | 2019-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871023002 | Joshua Kamau Njenga | Nurse Practitioner | 4412 Clarence Avenue, Saint Louis, MO 63115 | 2017-06-20 |
| 1417409178 | Carestl Health | Clinic/Center | 4265 Athlone Ave, Saint Louis, MO 63115 | 2016-10-28 |
| 1366806051 | Samar Roberson | Home Health | 4307 Steinlage Dr, Saint Louis, MO 63115 | 2016-04-08 |
| 1033376884 | Cornell C Thomas | Dentist | 3737 N Kings Highway, Suite 108, St Louis, MO 63115 | 2008-05-20 |
| 1033617386 | Carestl Health | Clinic/Center | 4500 Pope Ave, Saint Louis, MO 63115 | 2018-01-31 |
| 1023466984 | Carestl Health #4 | Durable Medical Equipment & Medical Supplies | 4500 Pope Ave, Saint Louis, MO 63115 | 2016-06-01 |
| 1164621538 | The Learning Tree Intergenerational Center Inc | Clinic/Center | 4430 Labadie Ave, St Louis, MO 63115 | 2007-07-16 |
| 1790845196 | Saint Louis Renal Care, LLC | Clinic/Center | 4411 N Newstead Ave, 2nd Floor, Saint Louis, MO 63115 | 2006-12-08 |
| 1245721331 | Paul Anthony Matthews Sr. | Home Health Aide | 5165 Ashland Ave, Saint Louis, MO 63115-1014 | 2018-05-23 |
| 1952946857 | Tiffany Nicole Stewart | Home Health | 5116 Greer Ave, Saint Louis, MO 63115-1017 | 2019-11-14 |
| Find all providers in zip 63115 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915910 | Lori Ann Williams | Clinic/Center | 6719 W Florissant Ave, Saint Louis, MO 63136-3634 | 2020-09-07 |
| 1376155390 | A Adult Day Care Inc | Clinic/Center | 6201 Michigan Ave, Saint Louis, MO 63111-2546 | 2020-08-20 |
| 1083235709 | Ann's Touch Adult Daycare LLC | Clinic/Center | 1514 Goodfellow Blvd, Saint Louis, MO 63112-3828 | 2020-05-04 |
| 1871124438 | Angels At Work Adult Daycare LLC | Clinic/Center | 7058 W Florissant Ave, Saint Louis, MO 63136-2561 | 2020-01-31 |
| 1922641810 | Edu Health PCs and Adc | Clinic/Center | 1841 Arrowpoint Dr, Saint Louis, MO 63138-6313 | 2019-10-23 |
| 1396309597 | Soc Care Center, LLC | Clinic/Center | 4029 Gravois Ave, Saint Louis, MO 63116-3622 | 2019-04-24 |
| 1760944912 | Divine Purpose Adult Daycare LLC | Clinic/Center | 1442 Chambers Rd, Saint Louis, MO 63135-2270 | 2019-04-04 |
| 1811459340 | Beyond Care Adult Daycare LLC | Clinic/Center | 5225 Delmar Blvd, Saint Louis, MO 63108-1027 | 2019-04-03 |
| 1568921450 | Lots of Love Adult Daycare, LLC | Clinic/Center | 9486 Lewis and Clark Blvd, Saint Louis, MO 63136-5104 | 2019-03-19 |
| 1871058560 | Tyrone Dumas | Clinic/Center | 12060 Bellefontaine Rd, Saint Louis, MO 63138-1903 | 2019-02-06 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63115 |
Please comment or provide details below to improve the information on CELEBRATION CITY COMMUNITY CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.