Provider Demographics
NPI:1376693978
Name:GIBSON PERSONAL SERVICES, LLC
Entity Type:Organization
Organization Name:GIBSON PERSONAL SERVICES, LLC
Other - Org Name:HEALING HEARTS PERSONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:210-738-9000
Mailing Address - Street 1:415 COUNTY ROAD 3823
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6934
Mailing Address - Country:US
Mailing Address - Phone:210-738-9000
Mailing Address - Fax:210-738-9018
Practice Address - Street 1:415 COUNTY ROAD 3823
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6934
Practice Address - Country:US
Practice Address - Phone:210-738-9000
Practice Address - Fax:210-738-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010694251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health