Healthcare Provider Details

I. General information

NPI: 1760884746
Provider Name (Legal Business Name): HEALTHY START MOMCARE NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 OLD SAINT AUGUSTINE RD STE E45
TALLAHASSEE FL
32301-4874
US

IV. Provider business mailing address

2002 OLD SAINT AUGUSTINE RD STE E45
TALLAHASSEE FL
32301-4874
US

V. Phone/Fax

Practice location:
  • Phone: 850-999-6200
  • Fax:
Mailing address:
  • Phone: 850-999-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN CHANG
Title or Position: COO
Credential:
Phone: 850-999-6200