Provider Demographics
NPI:1225365281
Name:GCN THERAPIES, INC.
Entity Type:Organization
Organization Name:GCN THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OCTAVIO
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-984-2701
Mailing Address - Street 1:5489 WILES RD STE 304
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4220
Mailing Address - Country:US
Mailing Address - Phone:954-984-2701
Mailing Address - Fax:954-414-8399
Practice Address - Street 1:5489 WILES RD STE 304
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4220
Practice Address - Country:US
Practice Address - Phone:954-984-2701
Practice Address - Fax:954-414-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty