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General NPI Number Information
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NPI Number | 1801012174
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Entity Type | Organization
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Legal Business Name | GBA HOMECARE SERVICES
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1554 E 195TH UP
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City | EUCLID
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State | OH
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Zip | 44117
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Country | US
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Telephone | 216-481-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 1554 E 195TH UP
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City | EUCLID
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State | OH
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Zip | 44117
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Country | US
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Telephone | 216-481-5450
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Fax |
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Authorized Official
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Title or Position | MEDICAL ASSISTANT CEO
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Name | MS. BURNICTRICS WEST
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Credential |
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Telephone | 216-481-5450
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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 | NONE
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License Number State | OH
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