Provider Demographics
NPI:1619718970
Name:STAY FOR THE DAY ADULT DAY CARE
Entity type:Organization
Organization Name:STAY FOR THE DAY ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLIBURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-502-6005
Mailing Address - Street 1:731 DUVAL STATION RD STE 107-265
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-0800
Mailing Address - Country:US
Mailing Address - Phone:904-502-6005
Mailing Address - Fax:
Practice Address - Street 1:731 DUVAL STATION RD STE 107-265
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-0800
Practice Address - Country:US
Practice Address - Phone:904-502-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care