Provider Demographics
NPI:1881406510
Name:S&GS LLC
Entity type:Organization
Organization Name:S&GS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AISAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-229-6157
Mailing Address - Street 1:1720 148TH LN NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-8487
Mailing Address - Country:US
Mailing Address - Phone:763-229-6157
Mailing Address - Fax:
Practice Address - Street 1:1720 148TH LN NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-8487
Practice Address - Country:US
Practice Address - Phone:763-229-6157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health