| NPI | 1487109633 |
|---|---|
| Doing Business As | GAMMA ROAD LODGE |
| Entity Type | Organization |
| Authorized Contact | MATHIAS P DASAL Member 573-481-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 043606) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-11-21 |