Provider Demographics
NPI:1497381370
Name:GDM SERVICES
Entity Type:Organization
Organization Name:GDM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:GENESSEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-742-7266
Mailing Address - Street 1:5810 SOUTHWYCK BLVD # 205P
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1518
Mailing Address - Country:US
Mailing Address - Phone:567-742-7266
Mailing Address - Fax:
Practice Address - Street 1:5810 SOUTHWYCK BLVD # 205P
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1518
Practice Address - Country:US
Practice Address - Phone:567-742-7266
Practice Address - Fax:567-742-7206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health