Provider Demographics
NPI:1902135288
Name:G&G ADMINISTRATIVE SERVICES LLC
Entity Type:Organization
Organization Name:G&G ADMINISTRATIVE SERVICES LLC
Other - Org Name:VISTA SERENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAMOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-283-1629
Mailing Address - Street 1:SAN JUAN TOWERS
Mailing Address - Street 2:1299 CARR 844 APT 803
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-283-1629
Mailing Address - Fax:787-283-1629
Practice Address - Street 1:CARR 844 KM 4.6 KAMINO PEDRO ANGULO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00986
Practice Address - Country:US
Practice Address - Phone:787-283-1629
Practice Address - Fax:787-283-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X, 314000000X
PR313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility