MEDICARE: GALILEE HOUSE L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1730046582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALILEE HOUSE L.L.C.

Provider Business Mailing Address
First Line	:	110 WHITTEMORE ST
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48342-3059
Country	:	US
Telephone Number	:	586-525-5138
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 WHITTEMORE ST
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48342-3059
Country	:	US
Telephone Number	:	586-525-5138
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROLAND WALKER III
Credential	:
Telephone Number	:	586-525-5138

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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