Provider Demographics
NPI:1245867951
Name:THE CLAIR WINSTON HOUSE,LLC
Entity type:Organization
Organization Name:THE CLAIR WINSTON HOUSE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANEI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:904-024-1079
Mailing Address - Street 1:132 W STANSELL AVE
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2056
Mailing Address - Country:US
Mailing Address - Phone:904-402-1079
Mailing Address - Fax:
Practice Address - Street 1:132 W STANSELL AVE
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2056
Practice Address - Country:US
Practice Address - Phone:904-402-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care