Provider Demographics
NPI:1366622649
Name:GAS INCE
Entity type:Organization
Organization Name:GAS INCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-933-4911
Mailing Address - Street 1:115 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1733
Mailing Address - Country:US
Mailing Address - Phone:636-933-4911
Mailing Address - Fax:636-933-9550
Practice Address - Street 1:122 E PRATT ST
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-2143
Practice Address - Country:US
Practice Address - Phone:636-337-8828
Practice Address - Fax:636-337-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness