Provider Demographics
NPI:1922546605
Name:HALLWAY HEALTHCARE
Entity Type:Organization
Organization Name:HALLWAY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-494-5378
Mailing Address - Street 1:11501 DUBLIN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2827
Mailing Address - Country:US
Mailing Address - Phone:925-452-8745
Mailing Address - Fax:925-558-4487
Practice Address - Street 1:11501 DUBLIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2827
Practice Address - Country:US
Practice Address - Phone:925-452-8745
Practice Address - Fax:925-558-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95050152251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health