Provider Demographics
NPI:1790309375
Name:DEAK-N-HALL, LLC
Entity Type:Organization
Organization Name:DEAK-N-HALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:LYND
Authorized Official - Last Name:DEAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-638-3894
Mailing Address - Street 1:15405 SE 105TH TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-4637
Mailing Address - Country:US
Mailing Address - Phone:352-638-3894
Mailing Address - Fax:
Practice Address - Street 1:510 HIGHWAY 466 STE 201A
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-6341
Practice Address - Country:US
Practice Address - Phone:352-638-3894
Practice Address - Fax:352-720-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-30
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care