PRESBYTERIAN SPEICAL SERVICES INC (NPI# 1417265737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417265737 |
| Entity Type | Organization |
| Organization Name | PRESBYTERIAN SPEICAL SERVICES INC |
| Other Organization Name | THE DUVALL HOME |
| Practice Address |
3395 Grand Ave Deland FL 32720-4507 |
| Mailing Address |
Po Box 220036 Glenwood FL 32722-0036 |
| Practice Telephone | 3867342874 |
| Practice Fax Number | 3867408185 |
| Mailing Telephone | 3867342874 |
| Mailing Fax Number | 3867408185 |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2010-09-21 |
| Authorized Official Name | MR. MARTIN FAVIS (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3867342874 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 09-12-063 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 023863596 | 05 |
| Other Name | Type Code |
|---|---|
| The Duvall Home | Doing Business As Name - Organization |
| Street Address |
3395 GRAND AVE |
| City | DELAND |
| State | FL |
| Zip Code | 32720-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568294 | Open Skyes Family Care Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5600 Sw 36th St, West Park, FL 33023-6106 | 2020-11-08 |
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1497368203 | Careola LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3248 Landing Vw, Tavares, FL 32778-2035 | 2020-08-31 |
| 1982218764 | The Home W/ Guiding Hands | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1256 N Florida Ave, Tarpon Springs, FL 34689-2004 | 2020-08-31 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1720691082 | Ohana In Home Senior Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 421 W Georgia St, Tallahassee, FL 32301-1011 | 2020-08-26 |
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1831700020 | Mikerline Lyns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10941 Winding Creek Ln, Boca Raton, FL 33428-5664 | 2020-08-12 |
| 1902416993 | Faith Care Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3800 Inverrary Blvd Ste 408d, Lauderhill, FL 33319-4359 | 2020-08-04 |
| 1063020188 | Kristine Kaiser Cravener | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1095 Beckman Dr, South Daytona, FL 32119-2499 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.