Provider Demographics
NPI:1194376525
Name:GAHC3 GARNER NC TRS SUB, LLC
Entity Type:Organization
Organization Name:GAHC3 GARNER NC TRS SUB, LLC
Other - Org Name:CADENCE GARNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-270-9200
Mailing Address - Street 1:18191 VON KARMAN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-7106
Mailing Address - Country:US
Mailing Address - Phone:949-270-9200
Mailing Address - Fax:949-474-0442
Practice Address - Street 1:200 MINGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-5273
Practice Address - Country:US
Practice Address - Phone:919-773-1500
Practice Address - Fax:919-773-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home