Provider Demographics
NPI:1174754006
Name:GEM PERSONAL CARE L.L.C.
Entity type:Organization
Organization Name:GEM PERSONAL CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:ED ADMIN
Authorized Official - Phone:702-875-1237
Mailing Address - Street 1:780 CORONADO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5040
Mailing Address - Country:US
Mailing Address - Phone:702-875-1237
Mailing Address - Fax:702-446-6748
Practice Address - Street 1:780 CORONADO CENTER DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5040
Practice Address - Country:US
Practice Address - Phone:702-875-1237
Practice Address - Fax:702-446-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5603PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care