1881820512 NPI number — ANNETTE M. WELLINGTON-HALL, INC

Table of content: (NPI 1881820512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881820512 NPI number — ANNETTE M. WELLINGTON-HALL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANNETTE M. WELLINGTON-HALL, INC
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:
SENIOR HELPERS
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:
1881820512
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5830 SHERIDAN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-437-9880
Provider Business Mailing Address Fax Number:
954-437-9881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5830 SHERIDAN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-437-9880
Provider Business Practice Location Address Fax Number:
954-437-9881
Provider Enumeration Date:
06/09/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WELLINGTON
Authorized Official First Name:
ANNETTE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
954-437-9880

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299993762 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X , with the licence number: 299993762 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 10D2012729 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347C00000X , with the licence number: 230571 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X , with the licence number: 299993762 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X , with the licence number: 29993762 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376K00000X , with the licence number: 29993762 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 230571 . This is a "ACHA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 299993762 . This is a "ACHA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".