Provider Demographics
NPI:1861740888
Name:GPS II
Entity type:Organization
Organization Name:GPS II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCDONOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-495-7769
Mailing Address - Street 1:6603 GULFSIDE RD
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-1416
Mailing Address - Country:US
Mailing Address - Phone:813-495-7769
Mailing Address - Fax:813-935-4771
Practice Address - Street 1:6603 GULFSIDE RD
Practice Address - Street 2:
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-1416
Practice Address - Country:US
Practice Address - Phone:813-495-7769
Practice Address - Fax:813-935-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-23
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty