1184170888 NPI number — GENTLE HEALING/CARE, INC.

Table of content: JASON WAYNE JONES RPA (NPI 1487091997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184170888 NPI number — GENTLE HEALING/CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENTLE HEALING/CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184170888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 E ALAMEDA AVE
Provider Second Line Business Mailing Address:
SUITE #302
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91502-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-588-4698
Provider Business Mailing Address Fax Number:
818-588-4698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 EAST ALAMEDA AVENUE
Provider Second Line Business Practice Location Address:
SUITE #302
Provider Business Practice Location Address City Name:
BURBANK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91502-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-588-4698
Provider Business Practice Location Address Fax Number:
818-588-4698
Provider Enumeration Date:
09/01/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DAVIDOVA
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
818-588-4698

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)