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General NPI Number Information
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NPI Number | 1639659147
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Entity Type | Organization
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Legal Business Name | HAILEY'S FAMILY SERVICES,LLC
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 21754 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33549-6901
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Country | US
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Telephone | 813-949-0745
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Fax |
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Provider Business Mailing Address
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Address Line | 9219 EVERWOOD CT
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City | TAMPA
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State | FL
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Zip | 33647-3298
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Country | US
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Telephone | 813-949-0745
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DEBRA L NATALE
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Credential |
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Telephone | 813-949-0745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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