Healthcare Provider Details

I. General information

NPI: 1588279210
Provider Name (Legal Business Name): GALLEON HOMECARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/13/2020
Certification Date: 09/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552382 US HIGHWAY 1
HILLIARD FL
32046-2328
US

IV. Provider business mailing address

552382 US HIGHWAY 1
HILLIARD FL
32046-2328
US

V. Phone/Fax

Practice location:
  • Phone: 904-675-9230
  • Fax: 904-675-9231
Mailing address:
  • Phone: 904-675-9230
  • Fax: 904-675-9231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA SABRINA CARTER
Title or Position: OWNER
Credential:
Phone: 904-675-9230