Provider Demographics
NPI:1720488299
Name:GIANT STRIDES HEALTH SERVICES
Entity Type:Organization
Organization Name:GIANT STRIDES HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:GORMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-683-6918
Mailing Address - Street 1:250 CLEARGIRL CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5920
Mailing Address - Country:US
Mailing Address - Phone:702-683-6918
Mailing Address - Fax:
Practice Address - Street 1:730 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2883
Practice Address - Country:US
Practice Address - Phone:702-683-6918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health