Provider Demographics
NPI:1093391336
Name:CASS'S MOBILE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CASS'S MOBILE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSONDRA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:386-871-3855
Mailing Address - Street 1:3956 SUNSET COVE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-1918
Mailing Address - Country:US
Mailing Address - Phone:386-871-3855
Mailing Address - Fax:
Practice Address - Street 1:3956 SUNSET COVE DR
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-1918
Practice Address - Country:US
Practice Address - Phone:386-871-3855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty