Provider Demographics
NPI:1588943070
Name:GKM HEALTHCARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:GKM HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:404-856-0505
Mailing Address - Street 1:760 OLD ROSWELL RD STE 211
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-8686
Mailing Address - Country:US
Mailing Address - Phone:404-856-0505
Mailing Address - Fax:404-602-0081
Practice Address - Street 1:760 OLD ROSWELL RD STE 211
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-8686
Practice Address - Country:US
Practice Address - Phone:404-856-0505
Practice Address - Fax:404-602-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003130697AMedicaid