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General NPI Number Information
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NPI Number | 1841837499
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Entity Type | Organization
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Legal Business Name | GEMINI GROUP, LLC
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 5045 E PARADISE LN
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1045
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Country | US
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Telephone | 602-494-7101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1213
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City | CAREFREE
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State | AZ
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Zip | 85377-1213
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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 | MANAGER
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Name | JENNIFER DEITCHMAN
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Credential |
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Telephone | 480-455-7975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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