Provider Demographics
NPI:1306062500
Name:EASTERN MISSOURI ALTERNATIVE SENTENCING SERVICES, INC.
Entity type:Organization
Organization Name:EASTERN MISSOURI ALTERNATIVE SENTENCING SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SATOP ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-946-2815
Mailing Address - Street 1:545 1ST CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2763
Mailing Address - Country:US
Mailing Address - Phone:636-946-2815
Mailing Address - Fax:636-946-1568
Practice Address - Street 1:545 1ST CAPITOL DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2763
Practice Address - Country:US
Practice Address - Phone:636-946-2815
Practice Address - Fax:636-946-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO6768741OtherDMH VENDOR #