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General NPI Number Information
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NPI Number | 1942164587
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Entity Type | Organization
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Legal Business Name | HAILEY'S WAY LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2043 GLENOAKS BLVD
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City | SAN FERNANDO
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State | CA
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Zip | 91340-1624
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Country | US
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Telephone | 818-277-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 18039 CHATSWORTH ST UNIT 3241
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5608
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Country | US
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Telephone | 818-277-1333
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT SMITH III
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Credential |
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Telephone | 818-277-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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