Provider Demographics
NPI:1851771687
Name:GEMS
Entity Type:Organization
Organization Name:GEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TRIZAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-210-4367
Mailing Address - Street 1:6334 ANGELITA VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-2813
Mailing Address - Country:US
Mailing Address - Phone:877-210-4367
Mailing Address - Fax:702-457-7661
Practice Address - Street 1:6334 ANGELITA VIEW AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-2813
Practice Address - Country:US
Practice Address - Phone:877-210-4367
Practice Address - Fax:702-457-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-07
Last Update Date:2015-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health