Provider Demographics
NPI:1588110233
Name:CASTLEPARKE PROPERTIES INC.
Entity type:Organization
Organization Name:CASTLEPARKE PROPERTIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOSTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-636-5300
Mailing Address - Street 1:304 WILDERNESS CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-1514
Mailing Address - Country:US
Mailing Address - Phone:573-636-5300
Mailing Address - Fax:573-636-5102
Practice Address - Street 1:304 WILDERNESS CT
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1514
Practice Address - Country:US
Practice Address - Phone:573-636-5300
Practice Address - Fax:573-636-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043806310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility