Provider Demographics
NPI:1770133118
Name:GGE ENTERPRISES LLC SUNSHINE CARE HOME I&II
Entity type:Organization
Organization Name:GGE ENTERPRISES LLC SUNSHINE CARE HOME I&II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-716-1659
Mailing Address - Street 1:3045 S TIOGA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3218
Mailing Address - Country:US
Mailing Address - Phone:224-716-1659
Mailing Address - Fax:
Practice Address - Street 1:3970 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4559
Practice Address - Country:US
Practice Address - Phone:702-914-9858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness