Halo, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

523-01 Issued in VA

Legal business name

HALO, INC.

Practice address

1857A Fort Mahone St
Petersburg, VA 23805-2761

Phone

(804) 733-9140

Fax

(804) 733-9216

NPI assigned

Feb 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harry Legros, QMRP/QMHP

Title

Executive Director

Phone

(804) 733-9140

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982677027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857A FORT MAHONE ST",
            "address_2": "P. O. BOX 28",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052761",
            "telephone_number": "804-733-9140",
            "fax_number": "804-733-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857A FORT MAHONE ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052761",
            "telephone_number": "804-733-9140",
            "fax_number": "804-733-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEGROS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-733-9140",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QMRP/QMHP"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "523-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.