# GEM INITIATIVE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043956394
- **Authorized official:** SOPHESIAS JOHNSON (ADMINISTRATOR/OW ER)
- **Authorized official phone:** (310) 749-5563

## Contact information

- **Practice address:** 700 E 80TH ST, LOS ANGELES, CA 90001-3210
- **Practice address phone:** (310) 720-7165
- **Mailing address:** 300 LONG BEACH BLVD UNIT 21139, LONG BEACH, CA 90801-7168
- **Mailing address phone:** (310) 749-5563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174200000X | Meals Provider | — | NULL | — |
| 177F00000X | Lodging Provider | — | NULL | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 251T00000X | PACE Provider Organization | — | NULL | — |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 310500000X | Mental Illness Intermediate Care Facility | — | NULL | — |
| 311Z00000X | Custodial Care Facility | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 05/10/2022
- **Last updated:** 01/17/2026