Healthcare Provider Details

I. General information

NPI: 1750663985
Provider Name (Legal Business Name): JUDY B. HAYMON HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4693 MAIN STREET-FYFFE
FYFFE AL
35971
US

IV. Provider business mailing address

4693 MAIN STREET-FYFFE
FYFFE AL
35971
US

V. Phone/Fax

Practice location:
  • Phone: 256-638-8479
  • Fax: 256-638-2738
Mailing address:
  • Phone: 256-638-8479
  • Fax: 256-638-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TEDDY HAYMON II
Title or Position: EXECUTIVE ADMINISTRATOR
Credential: RN
Phone: 256-638-8479