Organization
PROJECT HEALTH INC
Active
Other names
Langley Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E LIGHTY (CREDENTIALING SPECIALIST)
(352) 569-2964
Entity
Organization
Contact information
Practice address
300 S LINE AVE, INVERNESS, FL 34452-4606
(352) 419-5760
(888) 518-2037
Mailing address
1425 S US 301, SUMTERVILLE, FL 33585-5141
(352) 793-5900
(352) 793-6269
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
HCC9937
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029547723
—
FL
01
—
681140
MEDICARE FIRST COAST PART A
FL
01
—
K2260
MEDICARE FIRST COAST PART B
FL
Enumeration date
04/17/2018
Last updated
12/11/2023
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