Healthcare Provider Details

I. General information

NPI: 1346582483
Provider Name (Legal Business Name): HEYDAYS SENIOR DAY PROGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N GROVE ST
MERRITT ISLAND FL
32953-3444
US

IV. Provider business mailing address

210 N GROVE ST
MERRITT ISLAND FL
32953-3444
US

V. Phone/Fax

Practice location:
  • Phone: 321-474-8289
  • Fax:
Mailing address:
  • Phone: 321-474-8289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9166
License Number StateFL

VIII. Authorized Official

Name: MS. STACY SLAUGHTER
Title or Position: OWNER/OPERATOR
Credential:
Phone: 321-474-8289