Provider Demographics
NPI:1457696874
Name:GAY SENIOR SERVICES LLC
Entity Type:Organization
Organization Name:GAY SENIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEISSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-380-7952
Mailing Address - Street 1:1284 HAVENHURST DR
Mailing Address - Street 2:#104
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-4956
Mailing Address - Country:US
Mailing Address - Phone:323-380-7952
Mailing Address - Fax:
Practice Address - Street 1:1284 HAVENHURST DR
Practice Address - Street 2:#104
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-4956
Practice Address - Country:US
Practice Address - Phone:323-380-7952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health