Organization
GALLIANT NM LLC
Active
Parent organization
GALLIANT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GALLIANT LLC
Authorized official
ANDREW HOLDER (CO-FOUNDER)
(917) 608-5519
Entity
Organization
Contact information
Practice address
55 OLD SANTA FE TRL FL 2, SANTA FE, NM 87501-2009
(917) 608-5519
Mailing address
711 CARLSTON AVE, OAKLAND, CA 94610-2424
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/15/2020
Last updated
04/14/2021
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