Provider Demographics
NPI:1902552276
Name:GAIN LLC
Entity type:Organization
Organization Name:GAIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAIGWA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP
Authorized Official - Phone:602-579-9451
Mailing Address - Street 1:2623 N AUGUSTINE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-2051
Mailing Address - Country:US
Mailing Address - Phone:602-579-9451
Mailing Address - Fax:
Practice Address - Street 1:2623 N AUGUSTINE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-2051
Practice Address - Country:US
Practice Address - Phone:602-579-9451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health