Provider Demographics
NPI:1922871896
Name:GEEOLA LLC
Entity Type:Organization
Organization Name:GEEOLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANTAY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-756-4094
Mailing Address - Street 1:9960 63RD RD APT 7X
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1922
Mailing Address - Country:US
Mailing Address - Phone:917-756-4094
Mailing Address - Fax:
Practice Address - Street 1:9960 63RD RD APT 7X
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1922
Practice Address - Country:US
Practice Address - Phone:917-756-4094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency