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NPI Code Detail

MEDICARE: GIBBS CARE HOME, INC.

MEDICARE: GIBBS CARE HOME, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0850XAdult Mental Health Clinic/Center
3104100000XSocial Worker52231TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41016020OTHERTXDEPT OF AGING& DISABILITY
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508999194
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIBBS CARE HOME, INC.
Provider Business Mailing Address
First Line : PO BOX 451485
Second Line :
City : HOUSTON
State : TX
Zip : 77245-1485
Country : US
Telephone Number : 832-668-5323
Fax Number : 832-539-1299
Provider Business Practice Location Address
First Line : 5331 W OREM DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-5036
Country : US
Telephone Number : 832-668-5323
Fax Number : 832-539-1299
Authorized Official
Title or Position : FACILITY DIRECTOR
Name : GWENDOLYN ARNETTA GIBBS
Credential : MBA
Telephone Number : 832-668-5323
Provider Enumeration Date : 03/13/2007
Last Update Date : 05/17/2013

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Directions to “GIBBS CARE HOME, INC. ” Practice Location

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