Provider Demographics
NPI:1578046454
Name:GBL ENTERPRISES INC.
Entity Type:Organization
Organization Name:GBL ENTERPRISES INC.
Other - Org Name:THE WELLSTONE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-203-3187
Mailing Address - Street 1:126 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4752
Mailing Address - Country:US
Mailing Address - Phone:603-203-3187
Mailing Address - Fax:603-668-1899
Practice Address - Street 1:125 LANGFORD RD
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1710
Practice Address - Country:US
Practice Address - Phone:603-203-3187
Practice Address - Fax:603-668-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04283310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility