Provider Demographics
NPI:1356618128
Name:SGA PROPERTIES LLC
Entity type:Organization
Organization Name:SGA PROPERTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-518-8777
Mailing Address - Street 1:1598 KNOLLWAY DR
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-1406
Mailing Address - Country:US
Mailing Address - Phone:314-521-4144
Mailing Address - Fax:314-371-0466
Practice Address - Street 1:3922 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3502
Practice Address - Country:US
Practice Address - Phone:314-518-8777
Practice Address - Fax:314-371-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness