Provider Demographics
NPI:1508562091
Name:GELO LIFESTYLE CORP
Entity Type:Organization
Organization Name:GELO LIFESTYLE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LODIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EDOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-772-5474
Mailing Address - Street 1:6339 REDWOOD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-2738
Mailing Address - Country:US
Mailing Address - Phone:860-772-5474
Mailing Address - Fax:
Practice Address - Street 1:6339 REDWOOD OAKS DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-2738
Practice Address - Country:US
Practice Address - Phone:860-772-5474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health