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General NPI Number Information
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NPI Number | 1942487046
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Entity Type | Organization
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Legal Business Name | YVONNE R HALL
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 523 EASTLAKE CLUB DR
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City | OLDSMAR
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State | FL
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Zip | 34677-2472
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Country | US
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Telephone | 352-438-9242
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Fax | 727-772-5675
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Provider Business Mailing Address
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Address Line | 523 EASTLAKE CLUB DR
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City | OLDSMAR
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State | FL
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Zip | 34677-2472
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Country | US
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Telephone | 352-438-9242
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Fax | 727-772-5675
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Authorized Official
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Title or Position | OWNER
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Name | MS. YVONNE RENEE HALL
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Credential |
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Telephone | 352-438-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 693593100
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License Number State | FL
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