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General NPI Number Information
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NPI Number | 1821225210
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Entity Type | Organization
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Legal Business Name | EXPRESS HHA, INC
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 3911 W NEWBERRY RD SUITE B-2
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City | GAINESVILLE
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State | FL
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Zip | 32607-4820
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Country | US
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Telephone | 352-371-8600
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Fax | 352-338-1194
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Provider Business Mailing Address
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Address Line | 3911 W NEWBERRY RD SUITE B-2
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City | GAINESVILLE
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State | FL
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Zip | 32607-4820
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Country | US
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Telephone | 352-371-8600
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Fax | 352-338-1194
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ANTHONY ALLEN KALISHMAN
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Credential |
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Telephone | 352-371-8600
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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 | 299992736
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License Number State | FL
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