Provider Demographics
NPI:1225890791
Name:GABRIEL ENTERPRISES L.L.C.
Entity Type:Organization
Organization Name:GABRIEL ENTERPRISES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:757-842-3056
Mailing Address - Street 1:496 TRUMBLE LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-1471
Mailing Address - Country:US
Mailing Address - Phone:757-842-3056
Mailing Address - Fax:
Practice Address - Street 1:702 CITY CENTER BLVD STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3096
Practice Address - Country:US
Practice Address - Phone:757-706-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GABRIEL ENTERPRISES L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service