NPIMap

Organization Active NPI

Daytona Area Senior Services

Doing business as Halifax Health Care at Home

  • Home Health Agency
  • Daytona Beach, FL
National Provider Identifier
1194775395
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299992379 Issued in FL
Legal business name
DAYTONA AREA SENIOR SERVICES
Doing business as
Halifax Health Care at Home
Practice address
425 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone
(386) 236-0871
Fax
(386) 236-0873
NPI assigned
May 11, 2006
Last updated
Sep 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia Templeton
Title
Executive Director
Phone
(386) 425-3871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299992379 FL Primary

Addresses

Primary practice location

425 N Clyde Morris Blvd
Daytona Beach, FL 32114

Mailing address

425 N Clyde Morris Blvd
Daytona Beach, FL 32114-2730
Phone (386) 425-3871

Other names 1

  • Halifax Health Care at Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060721000167 FL Part A Provider - Home Health Agency 5890708606 Practice locations: Port Orange, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194775395. Details of each certification follow.

Home health agency certification: CCN 108359

Legal name
DAYTONA AREA SENIOR SERVICES
Doing business as
HALIFAX HEALTH CARE AT HOME
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 13, 2006
Last certification
May 10, 2018
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1996 in FL
Enrollment address
3800 Woodbriar TRL
Port Orange, FL 32129-9626

Care Compare: Home health agency

Medicare Care Compare
Listed as
Halifax Health Care at HomeCCN 108359 · All quality measures
Overall star rating
5 of 5
Ownership
Non-Profit
Certified
Oct 13, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1049347Daytona Area Senior Services3800 Woodbriar Trail 2ND Floor, Port Orange, FL 32129Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

160 N Beach St
Daytona Beach, FL 32114
Phone (386) 254-3874

425 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 236-0871

3800 Woodbriar Trl
Port Orange, FL 32129
Phone (386) 322-4701

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey Feasel Individual Corporate DirectorCeo Apr 4, 2000 95%
East Volusia Health Services Inc Organization, Daytona Beach, FL Corporation 5% Or Greater Direct Ownership Interest May 1, 2017 95%
Charlotte Somach Individual Corporate Director Aug 31, 2020 100%
W-2 Managing Employee Aug 31, 2020 100%
Council on Aging of Valousia County Inc Organization, Daytona Beach, FL Corporation 5% Or Greater Direct Ownership Interest May 1, 2010 5%
Husam E Eddin Individual Corporate DirectorMedical Director Jun 14, 2019 5%
Halifax Hospital Medical Center Organization, Daytona Beach, FL Corporation 5% Or Greater Indirect Ownership Interest May 1, 2017 95%
Shawn Remington Individual Corporate OfficerCfo Dec 18, 2023 5%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 53

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1194775395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142730",
            "telephone_number": "386-425-3871",
            "fax_number": "386-425-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-236-0871",
            "fax_number": "386-236-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTONA AREA SENIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "TEMPLETON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "386-425-3871"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halifax Health Care at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.