1013081215 NPI number — HALIFAX HEALTH SERVICES, LLC.

Table of content: (NPI 1013081215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013081215 NPI number — HALIFAX HEALTH SERVICES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HALIFAX HEALTH SERVICES, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACCENTCARE HOME HEALTH OF DAYTONA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013081215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 W MULBERRY ST
Provider Second Line Business Mailing Address:
SUITE 102 ATTN MECCA
Provider Business Mailing Address City Name:
DENTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-220-2074
Provider Business Mailing Address Fax Number:
888-504-4171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 W GRANADA BLVD STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORMOND BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32174-8157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-872-4700
Provider Business Practice Location Address Fax Number:
888-504-4171
Provider Enumeration Date:
11/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHWARTZ-DOTY
Authorized Official First Name:
DENA
Authorized Official Middle Name:
Authorized Official Title or Position:
AO
Authorized Official Telephone Number:
972-201-3819

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299992196 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)