MEDICARE: GALA MEDICAL & HEALTH CARE LLC

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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1780547257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALA MEDICAL & HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1570 LONGVIEW CIR
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-8060
Country	:	US
Telephone Number	:	720-318-4953
Fax Number	:	570-260-9943

Provider Business Practice Location Address
First Line	:	1570 LONGVIEW CIR
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-8060
Country	:	US
Telephone Number	:	720-318-4953
Fax Number	:	570-260-9943

Authorized Official
Title or Position	:	OWNER
Name	:	PETER GALA JR.
Credential	:	PMHNP-BC, FNP-C
Telephone Number	:	720-318-4953

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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