Provider Demographics
NPI:1124866314
Name:HUMBLED HANDZ ADULT DAYCARE
Entity type:Organization
Organization Name:HUMBLED HANDZ ADULT DAYCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NUSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:314-724-4354
Mailing Address - Street 1:32 PORTWEST CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5985
Mailing Address - Country:US
Mailing Address - Phone:314-280-6366
Mailing Address - Fax:
Practice Address - Street 1:32 PORTWEST CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5985
Practice Address - Country:US
Practice Address - Phone:314-280-6366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO119342180Medicaid
MO822675050Medicaid