Provider Demographics
NPI:1942685771
Name:GRAHAM GATTI MEMBERS ONLY ADULT CARE CLUB
Entity Type:Organization
Organization Name:GRAHAM GATTI MEMBERS ONLY ADULT CARE CLUB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-221-0654
Mailing Address - Street 1:239 W TIDWELL RD
Mailing Address - Street 2:SUITE F1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-1500
Mailing Address - Country:US
Mailing Address - Phone:346-221-0654
Mailing Address - Fax:
Practice Address - Street 1:239 W TIDWELL RD
Practice Address - Street 2:SUITE F1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-1500
Practice Address - Country:US
Practice Address - Phone:346-221-0654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care