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General NPI Number Information
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NPI Number | 1164488979
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Entity Type | Organization
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Legal Business Name | GBA HOLDING INC
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 1312 TEXAS AVE
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City | LUBBOCK
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State | TX
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Zip | 79401-4034
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Country | US
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Telephone | 806-472-6900
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Fax | 806-788-5571
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Provider Business Mailing Address
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Address Line | 12900 FOSTER ST SUITE 400
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | RUTH SCHWARTZ
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Credential |
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Telephone | 913-814-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 011445
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License Number State | TX
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