Greenwich Investors Gull Creek Operator LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GREENWICH INVESTORS GULL CREEK OPERATOR LLC

Practice address

1 Meadow St
Berlin, MD 21811-1309

Phone

(410) 641-3171

Fax

(410) 641-0104

NPI assigned

Sep 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg Echols

Title

Co-President of Management Agent

Phone

(779) 216-5849

Specialties & licenses 1

Addresses

Other names 1

• Gull Creek Senior Living Community Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1831672377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E COURT ST STE 400",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013848",
            "telephone_number": "815-935-1992",
            "fax_number": "815-935-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEADOW ST",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111309",
            "telephone_number": "410-641-3171",
            "fax_number": "410-641-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWICH INVESTORS GULL CREEK OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "ECHOLS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CO-PRESIDENT OF MANAGEMENT AGENT",
        "authorized_official_telephone_number": "779-216-5849"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gull Creek Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gull Creek Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lateisha Tiy Graham
• Gerardo Grasso Jr., MSW, LCSW-C
• Leah Marie Grauso, OTR
• Eric S. Gray, LCSWC
• Karin Gray
• Gail Greenwood
• Gregory S Russell, DMD, P.a.
• Abigail Elizabeth Grieninger
• William Edward Gunn, M.D.
• Jessica Skvarch Hadley, CRNA

• Assisted Living Facility in Berlin, MD
• Providers in Berlin, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.