Provider Demographics
NPI:1851979371
Name:GIBSAUNA GROUP INC
Entity Type:Organization
Organization Name:GIBSAUNA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIBSONALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-953-4097
Mailing Address - Street 1:425 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2533
Mailing Address - Country:US
Mailing Address - Phone:617-953-4097
Mailing Address - Fax:
Practice Address - Street 1:425 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2533
Practice Address - Country:US
Practice Address - Phone:617-953-4097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health