Provider Demographics
NPI:1619483757
Name:BALM OF GILEAD HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BALM OF GILEAD HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GALAMUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-202-6814
Mailing Address - Street 1:6408 81ST AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2510
Mailing Address - Country:US
Mailing Address - Phone:763-202-6814
Mailing Address - Fax:
Practice Address - Street 1:3300 BASS LAKE RD STE 320D
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3072
Practice Address - Country:US
Practice Address - Phone:763-432-6637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN385053251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health