Provider Demographics
NPI:1679169718
Name:GG PALS
Entity Type:Organization
Organization Name:GG PALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CASTILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:832-292-2978
Mailing Address - Street 1:1115 PANDORA ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5459
Mailing Address - Country:US
Mailing Address - Phone:832-292-2978
Mailing Address - Fax:
Practice Address - Street 1:1115 PANDORA ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5459
Practice Address - Country:US
Practice Address - Phone:832-292-2978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care