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General NPI Number Information
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NPI Number | 1962776575
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Entity Type | Organization
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Legal Business Name | GALLANT HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 702 VALIANT CIR
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City | GARLAND
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State | TX
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Zip | 75043-4923
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Country | US
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Telephone | 214-621-0965
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Fax | 214-666-3232
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Provider Business Mailing Address
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Address Line | 702 VALIANT CIR
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City | GARLAND
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State | TX
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Zip | 75043-4923
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Country | US
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Telephone | 214-621-0965
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Fax | 214-666-3232
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY ADEYEMO
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Credential | BS., CPA
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Telephone | 214-621-0965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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