Provider Demographics
NPI:1144769423
Name:GEMZSTAR, LLC
Entity Type:Organization
Organization Name:GEMZSTAR, LLC
Other - Org Name:RIGHT PLACE FOR SENIORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MA GEMMA
Authorized Official - Middle Name:DELA
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBS
Authorized Official - Phone:626-715-3759
Mailing Address - Street 1:5549 SANTA ANITA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780
Mailing Address - Country:US
Mailing Address - Phone:626-715-3759
Mailing Address - Fax:909-266-0070
Practice Address - Street 1:5549 SANTA ANITA AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2912
Practice Address - Country:US
Practice Address - Phone:626-715-3759
Practice Address - Fax:909-266-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201607610135251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management