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Organization
GILLEY ENTERPRISES LLC
Active
Organization
GILLEY ENTERPRISES LLC
Active
Other names
Eastern Mountain Family and Support Servcies, Eastern Mountain Family & Support Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN A GILLEY (CHIEF EXECUTIVE OFFICER)
(606) 821-6252
Entity
Organization
Contact information
Practice address
2381 HIGHWAY 7 S, JEREMIAH, KY 41826-9081
(606) 633-8058
(606) 633-2414
Mailing address
PO BOX 82, JEREMIAH, KY 41826-0082
(606) 633-8058
(606) 633-2414
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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