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General NPI Number Information
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NPI Number | 1982249207
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Entity Type | Organization
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Legal Business Name | G&O ENTERPRISE
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 5455 S MARTIN LUTHER KING JR BLVD
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City | LANSING
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State | MI
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Zip | 48911-3544
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Country | US
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Telephone | 517-642-5097
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Fax |
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Provider Business Mailing Address
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Address Line | 5455 S MARTIN LUTHER KING JR BLVD
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City | LANSING
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State | MI
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Zip | 48911-3544
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Country | US
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Telephone | 517-642-5097
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GARTH D HUTTON
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Credential | NP
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Telephone | 408-921-7062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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