Healthcare Provider Details
I. General information
NPI: 1053241950
Provider Name (Legal Business Name): HALTON ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1439 BURNING TREE RD
TARPON SPRINGS FL
34689-3801
US
IV. Provider business mailing address
1439 BURNING TREE RD
TARPON SPRINGS FL
34689-3801
US
V. Phone/Fax
- Phone: 386-847-4206
- Fax:
- Phone: 386-847-4206
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LADARIUS
HALTON
Title or Position: OWNER
Credential:
Phone: 386-847-4206