Organization
HALCYON PLACE LLC
Active
Other names
Halcyon Place LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA MOSS (OWNER)
(813) 210-4098
Entity
Organization
Contact information
Practice address
4125 TARTAN PL, TAMPA, FL 33624-5411
(813) 210-4098
Mailing address
3501 BESSIE COLEMAN BLVD UNIT 20254, TAMPA, FL 33622-9012
(813) 210-4098
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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