Provider Demographics
NPI:1710274980
Name:GERIATRIC HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:GERIATRIC HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEMAUD-GARNIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-714-8618
Mailing Address - Street 1:1035 S STATE ROAD 7
Mailing Address - Street 2:SUITE 315-21
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6134
Mailing Address - Country:US
Mailing Address - Phone:561-714-8618
Mailing Address - Fax:561-828-9272
Practice Address - Street 1:1035 S STATE ROAD 7
Practice Address - Street 2:SUITE 315-21
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6134
Practice Address - Country:US
Practice Address - Phone:561-714-8618
Practice Address - Fax:561-828-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7942103TC0700X
FLSW79031041C0700X
FLSW60761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6141AMedicare PIN