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General NPI Number Information
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NPI Number | 1972813665
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Entity Type | Organization
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Legal Business Name | GIFT PROFESSIONAL HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 2845 N GARLAND AVE 134
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City | GARLAND
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State | TX
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Zip | 75040-1968
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Country | US
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Telephone | 214-440-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 2845 N GARLAND AVE 134
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City | GARLAND
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State | TX
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Zip | 75040-1968
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Country | US
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Telephone | 214-440-7288
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Fax |
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Authorized Official
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Title or Position | DON
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Name | REGINA IYAWE
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Credential | RN BSN
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Telephone | 214-440-7288
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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 | 738171
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License Number State | TX
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