Provider Demographics
NPI:1336760842
Name:TOWNE SQUARE CARE OF GLADSTONE LLC
Entity Type:Organization
Organization Name:TOWNE SQUARE CARE OF GLADSTONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AIDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:865-387-7401
Mailing Address - Street 1:2900 NE KENDALLWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-1831
Mailing Address - Country:US
Mailing Address - Phone:865-387-7401
Mailing Address - Fax:615-622-8712
Practice Address - Street 1:2900 NE KENDALLWOOD PKWY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-1831
Practice Address - Country:US
Practice Address - Phone:865-387-7401
Practice Address - Fax:615-622-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility