Provider Demographics
NPI:1770295461
Name:GIBSON FAMILY SERVICES INC
Entity type:Organization
Organization Name:GIBSON FAMILY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-658-6540
Mailing Address - Street 1:425 HENRY SMITH RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-6604
Mailing Address - Country:US
Mailing Address - Phone:502-216-4172
Mailing Address - Fax:
Practice Address - Street 1:9000 WESSEX PL STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5071
Practice Address - Country:US
Practice Address - Phone:502-654-6540
Practice Address - Fax:502-206-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care