Provider Demographics
NPI:1780043232
Name:MCCALL SERVICE, INC.
Entity Type:Organization
Organization Name:MCCALL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-342-6948
Mailing Address - Street 1:2861 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-7472
Mailing Address - Country:US
Mailing Address - Phone:800-342-6948
Mailing Address - Fax:866-961-4919
Practice Address - Street 1:410 E PAUL RUSSELL RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6960
Practice Address - Country:US
Practice Address - Phone:800-342-6948
Practice Address - Fax:866-961-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJB1023311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility