Provider Demographics
NPI:1841703782
Name:GABRIEL'S NEST SIL INC
Entity type:Organization
Organization Name:GABRIEL'S NEST SIL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-789-8769
Mailing Address - Street 1:PO BOX 250275
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0275
Mailing Address - Country:US
Mailing Address - Phone:248-789-8769
Mailing Address - Fax:
Practice Address - Street 1:20312 RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2176
Practice Address - Country:US
Practice Address - Phone:248-789-8769
Practice Address - Fax:805-299-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health