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General NPI Number Information
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NPI Number | 1194775395
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Entity Type | Organization
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Legal Business Name | DAYTONA AREA SENIOR SERVICES
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 425 N CLYDE MORRIS BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114
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Country | US
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Telephone | 386-236-0871
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Fax | 386-236-0873
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Provider Business Mailing Address
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Address Line | 425 N CLYDE MORRIS BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2730
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Country | US
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Telephone | 386-425-3871
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Fax | 386-425-3873
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CYNTHIA TEMPLETON
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Credential |
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Telephone | 386-425-3871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299992379
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License Number State | FL
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