Provider Demographics
NPI:1821225210
Name:EXPRESS HHA, INC
Entity type:Organization
Organization Name:EXPRESS HHA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KALISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-371-8600
Mailing Address - Street 1:3911 W NEWBERRY RD
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4820
Mailing Address - Country:US
Mailing Address - Phone:352-371-8600
Mailing Address - Fax:352-338-1194
Practice Address - Street 1:3911 W NEWBERRY RD
Practice Address - Street 2:SUITE B-2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4820
Practice Address - Country:US
Practice Address - Phone:352-371-8600
Practice Address - Fax:352-338-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992736251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health