Healthcare Provider Details

I. General information

NPI: 1154568616
Provider Name (Legal Business Name): GFG MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 W. WAYLON JENNINGS BLVD.
LITTLEFIELD TX
79339-3716
US

IV. Provider business mailing address

144 N UTICA AVE
LUBBOCK TX
79416-3002
US

V. Phone/Fax

Practice location:
  • Phone: 806-385-4544
  • Fax: 806-385-4229
Mailing address:
  • Phone: 806-252-7218
  • Fax: 806-385-4229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. TAVA A. PORTER
Title or Position: MANAGING MEMBER
Credential:
Phone: 806-252-7218