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General NPI Number Information
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NPI Number | 1043956394
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Entity Type | Organization
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Legal Business Name | GEM INITIATIVE
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 700 E 80TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90001-3210
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Country | US
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Telephone | 310-720-7165
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LONG BEACH BLVD UNIT 21139
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City | LONG BEACH
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State | CA
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Zip | 90801-7168
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Country | US
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Telephone | 310-749-5563
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OW ER
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Name | SOPHESIAS JOHNSON
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Credential |
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Telephone | 310-749-5563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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