Provider Demographics
NPI:1407181795
Name:GASCONADE COUNTY BOARD FOR SERVICES FOR THE DEVELOPMENTALLY DISABLED
Entity Type:Organization
Organization Name:GASCONADE COUNTY BOARD FOR SERVICES FOR THE DEVELOPMENTALLY DISABLED
Other - Org Name:GASCONADE COUNTY SPECIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEINBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-437-5800
Mailing Address - Street 1:712 E HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-1588
Mailing Address - Country:US
Mailing Address - Phone:573-437-5800
Mailing Address - Fax:573-437-5801
Practice Address - Street 1:712 E HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-1588
Practice Address - Country:US
Practice Address - Phone:573-437-5800
Practice Address - Fax:573-437-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management