Provider Demographics
NPI:1932461126
Name:GS SENIOR CARE, LLC
Entity Type:Organization
Organization Name:GS SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDULAHI
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:HARUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-845-0003
Mailing Address - Street 1:3536 CARLIN SPRINGS RD
Mailing Address - Street 2:SUITE N9
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3003
Mailing Address - Country:US
Mailing Address - Phone:703-845-0003
Mailing Address - Fax:
Practice Address - Street 1:3536 CARLIN SPRINGS RD
Practice Address - Street 2:SUITE 9N
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3003
Practice Address - Country:US
Practice Address - Phone:703-845-0003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-151110251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-151110Medicaid
VAHCO-141110Medicaid