Provider Demographics
NPI:1891958393
Name:CALLAHAN HEALTH GROUP INC
Entity Type:Organization
Organization Name:CALLAHAN HEALTH GROUP INC
Other - Org Name:CALLAHAN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:LESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-879-1893
Mailing Address - Street 1:3545-1 ST. JOHNS BLUFF RD. S.
Mailing Address - Street 2:SUITE 352
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224
Mailing Address - Country:US
Mailing Address - Phone:904-998-7000
Mailing Address - Fax:904-998-7702
Practice Address - Street 1:449621 US HIGHWAY 301
Practice Address - Street 2:SUITE 210
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-9348
Practice Address - Country:US
Practice Address - Phone:904-998-7000
Practice Address - Fax:904-998-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization