Provider Demographics
NPI:1588279210
Name:GALLEON HOMECARE SERVICES, INC.
Entity type:Organization
Organization Name:GALLEON HOMECARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:SABRINA
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-675-9230
Mailing Address - Street 1:552382 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-2328
Mailing Address - Country:US
Mailing Address - Phone:904-675-9230
Mailing Address - Fax:904-675-9231
Practice Address - Street 1:552382 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:FL
Practice Address - Zip Code:32046-2328
Practice Address - Country:US
Practice Address - Phone:904-675-9230
Practice Address - Fax:904-675-9231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100315800Medicaid
FL10031580OtherGALLEON HOMECARE SERVICES INC