Provider Demographics
NPI:1790978625
Name:GS CONSULTING GROUP LLC
Entity Type:Organization
Organization Name:GS CONSULTING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:602-579-1917
Mailing Address - Street 1:4902 S VAL VISTA DR
Mailing Address - Street 2:SUITE B102
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-7325
Mailing Address - Country:US
Mailing Address - Phone:480-855-8866
Mailing Address - Fax:480-855-8867
Practice Address - Street 1:4902 S VAL VISTA DR
Practice Address - Street 2:SUITE B102
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-7325
Practice Address - Country:US
Practice Address - Phone:480-855-8866
Practice Address - Fax:480-855-8867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0718251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ137681Medicare UPIN
AZ133851Medicaid