Provider Demographics
NPI:1477990257
Name:GALILEO VENTURES LLC
Entity Type:Organization
Organization Name:GALILEO VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERSANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-235-2547
Mailing Address - Street 1:56 BULLARD RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-2204
Mailing Address - Country:US
Mailing Address - Phone:781-235-2547
Mailing Address - Fax:
Practice Address - Street 1:52 WAYSIDE AVE
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1316
Practice Address - Country:US
Practice Address - Phone:781-235-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care