Provider Demographics
NPI:1366959272
Name:GILLISPIE EMPLOYMENT & TRAINING SERVICES
Entity type:Organization
Organization Name:GILLISPIE EMPLOYMENT & TRAINING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILLISPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-499-8216
Mailing Address - Street 1:7475 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-2824
Mailing Address - Country:US
Mailing Address - Phone:409-499-8216
Mailing Address - Fax:409-767-8772
Practice Address - Street 1:990 IH 10 N
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1051
Practice Address - Country:US
Practice Address - Phone:409-499-8216
Practice Address - Fax:409-767-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health