Provider Demographics
NPI:1346577624
Name:GAP HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:GAP HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOVITA
Authorized Official - Middle Name:CHIBUZO
Authorized Official - Last Name:EZIRIM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:323-952-4250
Mailing Address - Street 1:945 S PRAIRIE AVE STE 201D
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-5270
Mailing Address - Country:US
Mailing Address - Phone:323-952-4250
Mailing Address - Fax:310-674-0340
Practice Address - Street 1:945 S PRAIRIE AVE STE 201D
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-5270
Practice Address - Country:US
Practice Address - Phone:323-952-4250
Practice Address - Fax:310-674-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-07
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health