MEDICARE: HALCYON REHABILITATION, LLC

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1700377025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALCYON REHABILITATION, LLC

Provider Business Mailing Address
First Line	:	2 BRIDGE ST STE 210
Second Line	:
City	:	IRVINGTON
State	:	NY
Zip	:	10533-1594
Country	:	US
Telephone Number	:	914-390-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3387 GULF BREEZE PKWY
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-3351
Country	:	US
Telephone Number	:	850-932-9257
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	CHRISTOPHER MCDONALD
Credential	:
Telephone Number	:	914-390-4300

Provider Enumeration Date	:	05/22/2018
Last Update Date	:	12/15/2021

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