Provider Demographics
NPI:1881986560
Name:GS INTEGRATED HEALTHCARE SYSTEMS, LLC.
Entity type:Organization
Organization Name:GS INTEGRATED HEALTHCARE SYSTEMS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEJUETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-893-3333
Mailing Address - Street 1:PO BOX 777851
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-7851
Mailing Address - Country:US
Mailing Address - Phone:702-893-3333
Mailing Address - Fax:702-893-0960
Practice Address - Street 1:2821 W. HORIZON RIDGE PKWY.
Practice Address - Street 2:SUITE #101
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-839-0091
Practice Address - Fax:702-413-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV6779HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCCN297191Medicare Oscar/Certification