Provider Demographics
NPI:1114763349
Name:ELDERFLOWER ADULT DAY CENTER
Entity type:Organization
Organization Name:ELDERFLOWER ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD NURSE
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-427-9329
Mailing Address - Street 1:1611 CHARLOTTE HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-9561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 CHARLOTTE HWY
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-9561
Practice Address - Country:US
Practice Address - Phone:708-691-3253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care