Provider Demographics
NPI:1891175303
Name:GALLANT GLOBAL INITIATIVE, INC.
Entity Type:Organization
Organization Name:GALLANT GLOBAL INITIATIVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ENDEE
Authorized Official - Middle Name:GALLANT
Authorized Official - Last Name:CHUONG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:443-360-8376
Mailing Address - Street 1:2601 PUTTY HILL AVE
Mailing Address - Street 2:A
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-4328
Mailing Address - Country:US
Mailing Address - Phone:443-600-0874
Mailing Address - Fax:888-909-6403
Practice Address - Street 1:2601 PUTTY HILL AVE
Practice Address - Street 2:A
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-4328
Practice Address - Country:US
Practice Address - Phone:443-600-0874
Practice Address - Fax:888-909-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNR130605251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care