Healthcare Provider Details

I. General information

NPI: 1427198969
Provider Name (Legal Business Name): HAMMOND STRAWBERRY FIELDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W THOMAS ST
HAMMOND LA
70401-3251
US

IV. Provider business mailing address

PO BOX 218
HAMMOND LA
70404-0218
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-1959
  • Fax: 985-542-6887
Mailing address:
  • Phone: 985-542-1959
  • Fax: 985-542-6887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number784
License Number StateLA

VIII. Authorized Official

Name: HELEN V ADDISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 985-542-1959