Provider Demographics
NPI:1104136332
Name:GAMEZ ON THE MOVE, LLC
Entity type:Organization
Organization Name:GAMEZ ON THE MOVE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:ZAAKIR
Authorized Official - Last Name:JIHAD
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:404-322-7970
Mailing Address - Street 1:290 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-1400
Mailing Address - Country:US
Mailing Address - Phone:850-590-4867
Mailing Address - Fax:
Practice Address - Street 1:290 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-1400
Practice Address - Country:US
Practice Address - Phone:850-590-4867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management