Provider Demographics
NPI:1922403831
Name:AL GALLON MINISTRIES
Entity Type:Organization
Organization Name:AL GALLON MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MINISTER
Authorized Official - Prefix:MR
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-986-3971
Mailing Address - Street 1:11530 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-3618
Mailing Address - Country:US
Mailing Address - Phone:813-986-3971
Mailing Address - Fax:813-672-1334
Practice Address - Street 1:11530 WALKER RD
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-3618
Practice Address - Country:US
Practice Address - Phone:813-986-3971
Practice Address - Fax:813-672-1334
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AL GALLON MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty