Provider Demographics
NPI:1487075750
Name:GAILAZ HOME HEALTH CARE AGENCY AND STAFFING SERVICES, INC
Entity type:Organization
Organization Name:GAILAZ HOME HEALTH CARE AGENCY AND STAFFING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:PEARL
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-776-7700
Mailing Address - Street 1:10034 210TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1045
Mailing Address - Country:US
Mailing Address - Phone:718-776-7700
Mailing Address - Fax:718-776-7701
Practice Address - Street 1:10034 210TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1045
Practice Address - Country:US
Practice Address - Phone:718-776-7700
Practice Address - Fax:718-776-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1478L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health