Provider Demographics
NPI:1982194494
Name:H-BAY MINISTRIES, INC.
Entity Type:Organization
Organization Name:H-BAY MINISTRIES, INC.
Other - Org Name:SUPERIOR RESIDENCES OF CLERMONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:850-583-7990
Mailing Address - Street 1:2528 BARRINGTON CIR # 2
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3888
Mailing Address - Country:US
Mailing Address - Phone:850-583-7990
Mailing Address - Fax:
Practice Address - Street 1:1600 HUNT TRACE BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5184
Practice Address - Country:US
Practice Address - Phone:352-394-5549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10160310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024991900Medicaid