Provider Demographics
NPI:1821573536
Name:GAJASPER SNF LLC
Entity Type:Organization
Organization Name:GAJASPER SNF LLC
Other - Org Name:GRANDVIEW HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZALMEN
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:OBERLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-316-1736
Mailing Address - Street 1:78 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTN STA
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:618 GENNETT DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-1143
Practice Address - Country:US
Practice Address - Phone:706-692-6323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility