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General NPI Number Information
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NPI Number | 1972089498
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Entity Type | Organization
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Legal Business Name | GC VENTURES AND CO.
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 6855 4TH ST NW STE B-2
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City | LOS RANCHOS
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State | NM
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Zip | 87107-6100
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Country | US
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Telephone | 505-508-2752
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Fax |
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Provider Business Mailing Address
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Address Line | 6855 4TH ST NW STE B-2
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City | LOS RANCHOS
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State | NM
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Zip | 87107-6100
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Country | US
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Telephone | 505-508-2752
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. EUGENA M LUCERO
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Credential | RN
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Telephone | 505-508-2752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN-
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License Number State | NM
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