=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558665356
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | G WOMEN INTERNATIONAL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2011
-----------------------------------------------------
Last Update Date | 01/18/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2451 S BUFFALO DR STE 138
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89117-2749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-776-8304
-----------------------------------------------------
Fax | 702-776-8095
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2451 S BUFFALO DR STE 138
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89117-2749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-776-8304
-----------------------------------------------------
Fax | 702-776-8095
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | GRACE GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-776-8304
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------