Provider Demographics
NPI:1164707717
Name:R.G.GASS ENTERPRISES INC.
Entity Type:Organization
Organization Name:R.G.GASS ENTERPRISES INC.
Other - Org Name:BRIGHTSTAR OF MAPLE GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:G
Authorized Official - Last Name:GASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-486-4023
Mailing Address - Street 1:7365 KIRKWOOD CT N
Mailing Address - Street 2:SUITE 345
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4721
Mailing Address - Country:US
Mailing Address - Phone:612-486-4400
Mailing Address - Fax:612-486-4480
Practice Address - Street 1:7365 KIRKWOOD CT N
Practice Address - Street 2:SUITE 345
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4721
Practice Address - Country:US
Practice Address - Phone:612-486-4400
Practice Address - Fax:612-486-4480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN352031251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health