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General NPI Number Information
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NPI Number | 1578810248
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Entity Type | Organization
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Legal Business Name | H AND J DONE RIGHT LLC
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Dates
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Enumeration Date | 08/12/2012
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Last Update Date | 08/12/2012
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Provider Practice Location Address
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Address Line | 7733 W SEVEN RIVERS DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-5494
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Country | US
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Telephone | 352-364-1655
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Fax | 352-795-6106
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Provider Business Mailing Address
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Address Line | 7733 W SEVEN RIVERS DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-5494
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Country | US
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Telephone | 352-364-1655
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Fax | 352-795-6106
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HAROLD CLAY MCKEOWN II
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Credential | GEN. CONTRACTOR
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Telephone | 352-364-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | CGC1519310
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License Number State | FL
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