Healthcare Provider Details

I. General information

NPI: 1790309375
Provider Name (Legal Business Name): DEAK-N-HALL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 LAUREL MANOR DR STE 135
THE VILLAGES FL
32162-5602
US

IV. Provider business mailing address

2520 S HIGHWAY 17
MURRELLS INLET SC
29576-7657
US

V. Phone/Fax

Practice location:
  • Phone: 352-720-6277
  • Fax: 843-651-1592
Mailing address:
  • Phone: 843-651-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: JAMIE LEE RECUPERO
Title or Position: COO
Credential: COO
Phone: 843-651-2273