Provider Demographics
NPI:1275992059
Name:SKILLSET LLC
Entity Type:Organization
Organization Name:SKILLSET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GUS
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-619-4131
Mailing Address - Street 1:1212 SATINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-1938
Mailing Address - Country:US
Mailing Address - Phone:573-619-4131
Mailing Address - Fax:
Practice Address - Street 1:319 CLAY MORGAN DR
Practice Address - Street 2:
Practice Address - City:EAST PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63845-9268
Practice Address - Country:US
Practice Address - Phone:573-619-4131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities