Provider Demographics
NPI:1700577327
Name:HALO HOMECARE LLC
Entity type:Organization
Organization Name:HALO HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAMICA
Authorized Official - Middle Name:LONETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:HOME CARE PROVIDER
Authorized Official - Phone:256-325-5023
Mailing Address - Street 1:250 SUN TEMPLE DR.
Mailing Address - Street 2:STE C5
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-0016
Mailing Address - Country:US
Mailing Address - Phone:256-325-5023
Mailing Address - Fax:256-325-5026
Practice Address - Street 1:250 SUN TEMPLE DR.
Practice Address - Street 2:STE C5
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-0016
Practice Address - Country:US
Practice Address - Phone:256-325-5023
Practice Address - Fax:256-325-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care