Provider Demographics
NPI:1124661087
Name:GASPARD'S HOME, INC
Entity type:Organization
Organization Name:GASPARD'S HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-929-6170
Mailing Address - Street 1:5065 SANCERRE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7471
Mailing Address - Country:US
Mailing Address - Phone:561-929-6170
Mailing Address - Fax:
Practice Address - Street 1:5065 SANCERRE CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7471
Practice Address - Country:US
Practice Address - Phone:561-929-6170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities