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General NPI Number Information
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NPI Number | 1437158714
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Entity Type | Organization
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Legal Business Name | GONZALES HEALTHCARE SYSTEMS
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 1314 N SARAH DEWITT DR
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City | GONZALES
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State | TX
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Zip | 78629-3314
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Country | US
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Telephone | 830-672-7581
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Fax | 830-672-2401
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Provider Business Mailing Address
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Address Line | PO BOX 587
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City | GONZALES
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State | TX
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Zip | 78629-0587
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Country | US
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Telephone | 830-672-7581
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Fax | 830-672-2401
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Authorized Official
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Title or Position | HOME HEALTH ADMINISTRATOR
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Name | MS. AMANDA FREDERICK
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Credential | MSN, RN
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Telephone | 830-672-9508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001500
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License Number State | TX
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