Provider Demographics
NPI:1851950430
Name:HALO STAFFING AGENCY, LLC
Entity type:Organization
Organization Name:HALO STAFFING AGENCY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-626-6168
Mailing Address - Street 1:6401 AKRON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2924
Mailing Address - Country:US
Mailing Address - Phone:877-425-6125
Mailing Address - Fax:215-395-6489
Practice Address - Street 1:6401 AKRON ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149
Practice Address - Country:US
Practice Address - Phone:877-425-6125
Practice Address - Fax:424-254-1367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALO STAFFING AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-07
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No282J00000XHospitalsReligious Nonmedical Health Care InstitutionGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038230500001Medicaid
PA1038230500001OtherPRIVATE-PAY
PA1851950430Medicaid