Provider Demographics
NPI:1750193777
Name:GINGER AVENUE LLC
Entity type:Organization
Organization Name:GINGER AVENUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOCONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-310-6546
Mailing Address - Street 1:105 GINGER AVE
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-1268
Mailing Address - Country:US
Mailing Address - Phone:214-310-6546
Mailing Address - Fax:
Practice Address - Street 1:105 GINGER AVE
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-1268
Practice Address - Country:US
Practice Address - Phone:214-310-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility