Provider Demographics
NPI:1790309375
Name:DEAK-N-HALL, LLC
Entity type:Organization
Organization Name:DEAK-N-HALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RECUPERO
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:843-651-2273
Mailing Address - Street 1:2520 S HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7657
Mailing Address - Country:US
Mailing Address - Phone:843-651-2273
Mailing Address - Fax:
Practice Address - Street 1:1950 LAUREL MANOR DR STE 135
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5602
Practice Address - Country:US
Practice Address - Phone:352-720-6277
Practice Address - Fax:843-651-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-30
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization