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General NPI Number Information
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NPI Number | 1356935621
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Entity Type | Organization
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Legal Business Name | CLAYTON HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 6418 BLACK DAIRY RD
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City | SEFFNER
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State | FL
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Zip | 33584-2912
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Country | US
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Telephone | 813-399-4982
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Fax |
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Provider Business Mailing Address
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Address Line | 6418 BLACK DAIRY RD
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City | SEFFNER
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State | FL
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Zip | 33584-2912
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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 | OWNER
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Name | TIFFENY CLAYTON
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Credential |
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Telephone | 813-399-4982
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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 |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | NULL
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