Provider Demographics
NPI:1922641802
Name:GABLES CANTON
Entity Type:Organization
Organization Name:GABLES CANTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISSY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:CEAL
Authorized Official - Phone:330-209-2128
Mailing Address - Street 1:3660 GREENTREE AVE SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-4024
Mailing Address - Country:US
Mailing Address - Phone:330-209-2128
Mailing Address - Fax:
Practice Address - Street 1:3660 GREENTREE AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-4024
Practice Address - Country:US
Practice Address - Phone:330-209-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care