MEDICARE: THE HOUSE NEXT DOOR, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1264AD5284	FL
2	1041C0700X	Clinical Social Worker	1264AD5284	FL
3	106H00000X	Marriage & Family Therapist	1264AD5284	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326075300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HOUSE NEXT DOOR, INC.

Provider Business Mailing Address
First Line	:	804 N. WOODLAND BLVD.
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720
Country	:	US
Telephone Number	:	386-734-7571
Fax Number	:	386-734-0252

Provider Business Practice Location Address
First Line	:	804 N WOODLAND BLVD
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-2709
Country	:	US
Telephone Number	:	386-734-7571
Fax Number	:	386-734-0252

Authorized Official
Title or Position	:	OPERATIONS DIRECTOR
Name	:	MS. GAIL W HALLMON
Credential	:
Telephone Number	:	386-734-4233

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	09/11/2025

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