Provider Demographics
NPI:1134954290
Name:THE HALL TEAM LLC
Entity type:Organization
Organization Name:THE HALL TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:816-590-8551
Mailing Address - Street 1:5960 GETWELL RD STE 212A
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-7320
Mailing Address - Country:US
Mailing Address - Phone:662-932-2828
Mailing Address - Fax:
Practice Address - Street 1:5960 GETWELL RD STE 212A
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-7320
Practice Address - Country:US
Practice Address - Phone:662-932-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care