Organization Name: | CHARLES P. GALLO |
NPI Number: | 1003109430 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES P GALLO (OWNER) |
Mailing Address: | 2550 Mosside Blvd Suite 304 Monroeville |
State: | PA US |
Postal Code: | 151463540 |
Phone Number: | 4123733471 |
Fax Number: | 4123737324 |
NPI Enumeration Date: | 05/18/2011 |
NPI Last Update Date: | 05/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |