Provider Demographics
NPI:1568741262
Name:GLADSTONE HEADQUARTERS, INC
Entity Type:Organization
Organization Name:GLADSTONE HEADQUARTERS, INC
Other - Org Name:AMERICAN MEDICAL PERSONNEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-433-1080
Mailing Address - Street 1:717 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-3009
Mailing Address - Country:US
Mailing Address - Phone:330-433-1080
Mailing Address - Fax:330-433-1086
Practice Address - Street 1:717 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-3009
Practice Address - Country:US
Practice Address - Phone:330-433-1080
Practice Address - Fax:330-433-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care