Provider Demographics
NPI:1598161713
Name:GABE'S HOMES
Entity Type:Organization
Organization Name:GABE'S HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, CAC
Authorized Official - Phone:714-334-8180
Mailing Address - Street 1:3620 E SHALLOW BROOK LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2088
Mailing Address - Country:US
Mailing Address - Phone:714-345-3445
Mailing Address - Fax:714-969-6464
Practice Address - Street 1:14061 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4262
Practice Address - Country:US
Practice Address - Phone:714-345-3445
Practice Address - Fax:714-969-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT20956261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder