Provider Demographics
NPI:1326659541
Name:THE BALM IN GILEAD, INC
Entity Type:Organization
Organization Name:THE BALM IN GILEAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PERNESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-644-2256
Mailing Address - Street 1:620 MOOREFIELD PARK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3680
Mailing Address - Country:US
Mailing Address - Phone:804-644-2256
Mailing Address - Fax:
Practice Address - Street 1:620 MOOREFIELD PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3680
Practice Address - Country:US
Practice Address - Phone:804-644-2256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution