Provider Demographics
NPI:1790654424
Name:GALLANT CARE LLC
Entity type:Organization
Organization Name:GALLANT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELMARTHY JANETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLARDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-708-5346
Mailing Address - Street 1:309 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2327
Mailing Address - Country:US
Mailing Address - Phone:562-708-5346
Mailing Address - Fax:
Practice Address - Street 1:6841 OBISPO AVE APT C
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-1977
Practice Address - Country:US
Practice Address - Phone:562-708-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-31
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care