Provider Demographics
NPI:1235448077
Name:HALO NETWORK, INC
Entity Type:Organization
Organization Name:HALO NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUBUNMI
Authorized Official - Middle Name:OLUYINKA
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:631-789-7373
Mailing Address - Street 1:221 BROADWAY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2780
Mailing Address - Country:US
Mailing Address - Phone:631-789-7373
Mailing Address - Fax:631-789-7383
Practice Address - Street 1:221 BROADWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2780
Practice Address - Country:US
Practice Address - Phone:631-789-7373
Practice Address - Fax:631-789-7383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0510491041C0700X
NY065966251B00000X, 251C00000X, 251S00000X, 251V00000X, 251X00000X, 252Y00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty