Provider Demographics
NPI:1467771667
Name:HALO-HEALTH AWARENESS LEARNING ORGANIZATION
Entity Type:Organization
Organization Name:HALO-HEALTH AWARENESS LEARNING ORGANIZATION
Other - Org Name:THE BRIAN E. CARTER CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER/PATIENT EDUCATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-713-1434
Mailing Address - Street 1:145 CAMBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2409
Mailing Address - Country:US
Mailing Address - Phone:757-349-4256
Mailing Address - Fax:
Practice Address - Street 1:145 CAMBRIDGE PL
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2409
Practice Address - Country:US
Practice Address - Phone:757-349-4256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA116858302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization