Healthcare Provider Details

I. General information

NPI: 1407767817
Provider Name (Legal Business Name): GALORE ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 GLENWOOD AVE STE 200
RALEIGH NC
27612-3857
US

IV. Provider business mailing address

4801 GLENWOOD AVE STE 200
RALEIGH NC
27612-3857
US

V. Phone/Fax

Practice location:
  • Phone: 323-627-5759
  • Fax:
Mailing address:
  • Phone: 323-627-5759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PIERRE KAKU
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 323-627-5759