Provider Demographics
NPI:1851419774
Name:GABRIEL CARE LLC
Entity Type:Organization
Organization Name:GABRIEL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:ETZKORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-678-1002
Mailing Address - Street 1:261 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-2917
Mailing Address - Country:US
Mailing Address - Phone:508-678-1002
Mailing Address - Fax:508-678-1042
Practice Address - Street 1:261 OLIVER ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2917
Practice Address - Country:US
Practice Address - Phone:508-678-1002
Practice Address - Fax:508-678-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905171Medicaid