Provider Demographics
NPI:1457122897
Name:THE GATHERING ASSISTANT LIVING
Entity Type:Organization
Organization Name:THE GATHERING ASSISTANT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FATU
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:DARPOH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:610-741-7437
Mailing Address - Street 1:18962 HELEN WAY
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-4718
Mailing Address - Country:US
Mailing Address - Phone:610-741-7437
Mailing Address - Fax:610-741-7437
Practice Address - Street 1:18962 HELEN WAY
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309-4718
Practice Address - Country:US
Practice Address - Phone:610-741-7437
Practice Address - Fax:610-741-7437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness