=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417743162
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MH HEALTH CARE SERVICES, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2025
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 ZEAGLER DR STE 4
-----------------------------------------------------
City | PALATKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32177-3826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-309-5455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 W MARKET ST STE 2900
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46204-2964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-434-3255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | TERRY LAYMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 317-522-0844
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------