Provider Demographics
NPI:1760089502
Name:GAH2 LLC
Entity Type:Organization
Organization Name:GAH2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-443-0014
Mailing Address - Street 1:222 NEIGHBORHOOD MARKET RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3525
Mailing Address - Country:US
Mailing Address - Phone:407-530-0543
Mailing Address - Fax:
Practice Address - Street 1:222 NEIGHBORHOOD MARKET RD STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3525
Practice Address - Country:US
Practice Address - Phone:407-530-0543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric