Provider Demographics
NPI:1417494527
Name:GNG MANAGEMENT GROUP INC
Entity Type:Organization
Organization Name:GNG MANAGEMENT GROUP INC
Other - Org Name:ARIZONA SENIOR LIVING HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANESYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-599-0522
Mailing Address - Street 1:7405 W CREST LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15213 N 55TH WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8204
Practice Address - Country:US
Practice Address - Phone:818-599-0522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9821H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility