Provider Demographics
NPI:1639659147
Name:HAILEY'S FAMILY SERVICES,LLC
Entity Type:Organization
Organization Name:HAILEY'S FAMILY SERVICES,LLC
Other - Org Name:HAILEY'S FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NATALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-949-0745
Mailing Address - Street 1:9219 EVERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3298
Mailing Address - Country:US
Mailing Address - Phone:813-949-0745
Mailing Address - Fax:
Practice Address - Street 1:21754 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6901
Practice Address - Country:US
Practice Address - Phone:813-949-0745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAILEY'S FAMILY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty