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General NPI Number Information
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NPI Number | 1104136332
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Entity Type | Organization
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Legal Business Name | GAMEZ ON THE MOVE, LLC
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 290 W WASHINGTON ST
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City | MONTICELLO
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State | FL
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Zip | 32344-1400
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Country | US
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Telephone | 850-590-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 290 W WASHINGTON ST
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City | MONTICELLO
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State | FL
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Zip | 32344-1400
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Country | US
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Telephone | 850-590-4867
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ISMAIL ZAAKIR JIHAD
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Credential | ED. D
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Telephone | 404-322-7970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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