Provider Demographics
NPI:1922485630
Name:GEMS65 & OLDER PLUS MORE
Entity Type:Organization
Organization Name:GEMS65 & OLDER PLUS MORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-513-4064
Mailing Address - Street 1:325 N. ST. PAUL
Mailing Address - Street 2:STE. 3100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201
Mailing Address - Country:US
Mailing Address - Phone:469-513-4064
Mailing Address - Fax:
Practice Address - Street 1:325 N. ST. PAUL
Practice Address - Street 2:STE. 3100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:469-513-4064
Practice Address - Fax:469-513-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No251V00000XAgenciesVoluntary or Charitable
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)