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General NPI Number Information
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NPI Number | 1265920755
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Entity Type | Organization
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Legal Business Name | GRAYSON UNITED ASSOCIATES
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 300 N RONALD REAGAN BLVD STE 300
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City | LONGWOOD
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State | FL
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Zip | 32750-5902
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Country | US
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Telephone | 407-346-4818
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N RONALD REAGAN BLVD STE 300
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City | LONGWOOD
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State | FL
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Zip | 32750-5902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AREA DIRECTOR
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Name | NASHAE HALL
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Credential |
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Telephone | 73-464-8184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 299994761
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License Number State | FL
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