Healthcare Provider Details

I. General information

NPI: 1891837183
Provider Name (Legal Business Name): HAMILTON SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 REVOLUTION MILL DR. STUDIO 1
GREENSBORO NC
27405-5041
US

IV. Provider business mailing address

975 REVOLUTION MILL DR. STUDIO 1
GREENSBORO NC
27405-5041
US

V. Phone/Fax

Practice location:
  • Phone: 336-389-1142
  • Fax: 336-373-3996
Mailing address:
  • Phone: 336-389-1142
  • Fax: 336-373-3996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PAGE H ALBERTS
Title or Position: CEO
Credential:
Phone: 336-389-1142