Provider Demographics
NPI:1558777375
Name:GVNA HEALTH CARE, INC
Entity Type:Organization
Organization Name:GVNA HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUET
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:978-632-1230
Mailing Address - Street 1:34 PEARLY LANE
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1471 MAIN STREET REAR
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-2637
Practice Address - Country:US
Practice Address - Phone:978-248-9530
Practice Address - Fax:978-632-4513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GVNA HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110024155EMedicaid