Provider Demographics
NPI:1801012174
Name:GBA HOMECARE SERVICES
Entity Type:Organization
Organization Name:GBA HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BURNICTRICS
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-481-5450
Mailing Address - Street 1:1554 E 195TH
Mailing Address - Street 2:UP
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117
Mailing Address - Country:US
Mailing Address - Phone:216-481-5450
Mailing Address - Fax:
Practice Address - Street 1:1554 E 195TH
Practice Address - Street 2:UP
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117
Practice Address - Country:US
Practice Address - Phone:216-481-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNONE251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health