Provider Demographics
NPI:1013806199
Name:G & G HOME ENTERPRISE LLC
Entity type:Organization
Organization Name:G & G HOME ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-888-4552
Mailing Address - Street 1:9099 POTTERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:MI
Mailing Address - Zip Code:48191-9504
Mailing Address - Country:US
Mailing Address - Phone:313-888-4552
Mailing Address - Fax:
Practice Address - Street 1:8710 W DAVISON
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-3002
Practice Address - Country:US
Practice Address - Phone:313-307-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities