Provider Demographics
NPI:1699100297
Name:GAIL'S GARDEN OF GOLD CORPORATION
Entity type:Organization
Organization Name:GAIL'S GARDEN OF GOLD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:BROOKLIN
Authorized Official - Last Name:EAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-432-7400
Mailing Address - Street 1:904 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5510
Mailing Address - Country:US
Mailing Address - Phone:336-432-7400
Mailing Address - Fax:336-623-7016
Practice Address - Street 1:904 IRVING AVE
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5510
Practice Address - Country:US
Practice Address - Phone:336-432-7400
Practice Address - Fax:336-623-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities