Organization
GEMS65 & OLDER PLUS MORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE JACKSON (DIRECTOR)
(469) 513-4064
Entity
Organization
Contact information
Practice address
325 N. ST. PAUL, STE. 3100, DALLAS, TX 75201
(469) 513-4064
(469) 513-4001
Mailing address
325 N. ST. PAUL, STE. 3100, DALLAS, TX 75201
(469) 513-4064
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/01/2015
Last updated
05/11/2015
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