Provider Demographics
NPI:1952587701
Name:HOUSE OF GABRIEL LLC.
Entity Type:Organization
Organization Name:HOUSE OF GABRIEL LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:MICHEL'E
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-996-7676
Mailing Address - Street 1:4102 PEPPERTREE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2691
Mailing Address - Country:US
Mailing Address - Phone:301-996-7676
Mailing Address - Fax:
Practice Address - Street 1:4102 PEPPERTREE LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2691
Practice Address - Country:US
Practice Address - Phone:301-996-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities