Provider Demographics
NPI:1083499495
Name:DHH CONNECT
Entity Type:Organization
Organization Name:DHH CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSDE
Authorized Official - Phone:248-564-8453
Mailing Address - Street 1:1232 MARILYN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-7689
Mailing Address - Country:US
Mailing Address - Phone:305-501-0630
Mailing Address - Fax:
Practice Address - Street 1:1232 MARILYN LN
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-7689
Practice Address - Country:US
Practice Address - Phone:305-501-0630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center