HEARTHSTONE FELLOWSHIP FOUNDATION, INC (NPI# 1881003101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881003101 |
| Entity Type | Organization |
| Organization Name | HEARTHSTONE FELLOWSHIP FOUNDATION, INC |
| Practice Address |
814 N Beach St Daytona Beach FL 32114-2234 |
| Practice Telephone | 3862381348 |
| Practice Fax Number | 3862380171 |
| Mailing Telephone | 3862381348 |
| Mailing Fax Number | 3862380171 |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |
| Authorized Official Name | JANET G. MINOR (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 3862381348 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
0764AD071101 | FL | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HEARTHSTONE FELLOWSHIP FOUNDATION, INC. | 814 N Beach St, Daytona Beach, FL 32114-2234 |
| Street Address |
814 N BEACH ST |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
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| 1164815106 | Chance 2 Change | Clinic/Center | 724 S Beach St, Suite 3, Daytona Beach, FL 32114-5441 | 2015-03-16 |
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| 1982268058 | M.a.t. of The Palm Beaches LLC | Clinic/Center | 321 Northlake Blvd Ste 116, North Palm Beach, FL 33408-5410 | 2019-04-24 |
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| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on HEARTHSTONE FELLOWSHIP FOUNDATION, INC.
| 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.