Provider Demographics
NPI:1992258230
Name:GTMS FITNESS CORPORATION
Entity type:Organization
Organization Name:GTMS FITNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:BEA
Authorized Official - Last Name:OLIVES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-249-2256
Mailing Address - Street 1:21245 AVENIDA DE ARBOLES
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9319
Mailing Address - Country:US
Mailing Address - Phone:951-249-2256
Mailing Address - Fax:951-304-7680
Practice Address - Street 1:39815 ALTA MURRIETA DR
Practice Address - Street 2:SUITE C-1
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-5459
Practice Address - Country:US
Practice Address - Phone:951-304-7673
Practice Address - Fax:951-304-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555705313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility