Provider Demographics
NPI:1871753467
Name:RASSE SATOP, LLC
Entity type:Organization
Organization Name:RASSE SATOP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SATOP DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RASSE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC,QSAP
Authorized Official - Phone:660-886-3373
Mailing Address - Street 1:78 W ARROW ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-2105
Mailing Address - Country:US
Mailing Address - Phone:660-886-3373
Mailing Address - Fax:660-886-3372
Practice Address - Street 1:78 W ARROW ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-2105
Practice Address - Country:US
Practice Address - Phone:660-886-3373
Practice Address - Fax:660-886-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO084251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO084OtherDEPARTMENT OF MENTAL HEALTH, DIVISION OF ALCOHOL & DRUG ABUSE, SATOP