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General NPI Number Information
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NPI Number | 1275110694
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Entity Type | Organization
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Legal Business Name | GPS4VETS
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 16424 S WESTERN AVE STE 1
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City | GARDENA
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State | CA
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Zip | 90247-4679
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Country | US
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Telephone | 909-438-1668
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Fax |
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Provider Business Mailing Address
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Address Line | 16424 S WESTERN AVE STE 1
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City | GARDENA
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State | CA
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Zip | 90247-4679
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Country | US
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Telephone | 909-438-1668
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | ALICIA GAVIN-JONES
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Credential |
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Telephone | 909-438-1668
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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