Provider Demographics
NPI:1659878023
Name:GBX2 INC
Entity Type:Organization
Organization Name:GBX2 INC
Other - Org Name:A PLACE AT HOME SOUTH DENVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-726-3799
Mailing Address - Street 1:11981 S ALLERTON CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8828
Mailing Address - Country:US
Mailing Address - Phone:303-330-1026
Mailing Address - Fax:
Practice Address - Street 1:19039 PLAZA DR STE 230
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9028
Practice Address - Country:US
Practice Address - Phone:720-726-3799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04D455251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health