Provider Demographics
NPI:1669426748
Name:HAYSWOOD HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:HAYSWOOD HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNLYN
Authorized Official - Middle Name:FURNIER
Authorized Official - Last Name:PURDON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MACC
Authorized Official - Phone:606-564-9481
Mailing Address - Street 1:207 STANLEY REED CT
Mailing Address - Street 2:FL3
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-1105
Mailing Address - Country:US
Mailing Address - Phone:606-564-9481
Mailing Address - Fax:606-564-9484
Practice Address - Street 1:1 W MCDONALD PKWY
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-1164
Practice Address - Country:US
Practice Address - Phone:606-564-9481
Practice Address - Fax:606-564-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150025252Y00000X, 251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3400381400Medicaid
KY4534113800Medicaid
KY3400381400Medicaid
KY4200181800Medicaid