Provider Demographics
NPI:1952767162
Name:G & G LIVING CENTERS, INC.
Entity type:Organization
Organization Name:G & G LIVING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:AGNES
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-252-3811
Mailing Address - Street 1:P.O. BOX 967
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-0967
Mailing Address - Country:US
Mailing Address - Phone:563-252-3811
Mailing Address - Fax:563-252-3812
Practice Address - Street 1:602 KOSCIUSKO ST.
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-0967
Practice Address - Country:US
Practice Address - Phone:563-252-3811
Practice Address - Fax:563-252-3812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000128025Medicaid