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Organization
HALO HOMECARE LLC
Active
Organization
HALO HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYSHA WOODYE PMHNP (NURSE PRACITIONER)
(207) 400-5188
Entity
Organization
Contact information
Practice address
54 DOROTHY ST, PORTLAND, ME 04103-1121
(207) 400-5188
Mailing address
PO BOX 1862, PORTLAND, ME 04104-1862
(207) 400-5188
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
09/16/2026
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