Provider Demographics
NPI:1205358694
Name:GPCH, LLC
Entity Type:Organization
Organization Name:GPCH, LLC
Other - Org Name:LIGHTHOUSE-BORGER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SLATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-467-5707
Mailing Address - Street 1:100 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-7579
Mailing Address - Country:US
Mailing Address - Phone:806-467-5707
Mailing Address - Fax:806-467-5726
Practice Address - Street 1:100 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-7579
Practice Address - Country:US
Practice Address - Phone:806-467-5707
Practice Address - Fax:806-467-5726
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GPCH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty