Provider Demographics
NPI:1861115206
Name:HALCYON HOME CARE LLC
Entity type:Organization
Organization Name:HALCYON HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-283-5500
Mailing Address - Street 1:73 CAVALIER BLVD STE 127
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5180
Mailing Address - Country:US
Mailing Address - Phone:859-283-5500
Mailing Address - Fax:
Practice Address - Street 1:73 CAVALIER BLVD STE 127
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5180
Practice Address - Country:US
Practice Address - Phone:859-283-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care